Unknown Individual – Mental Health Counselor, NPI 1417039900

Unknown Individual is a healthcare provider. based in Portland, Oregon. specializing in Mental Health Counselor. They hold a License No. 1287 (OR). The NPI Number for Unknown Individual is 1417039900

Main info

Organization
Inactive
Name
Unknown Individual
NPI
1417039900
Phone
(503) 246-6743
Address
8023 SW 31 AV.
Deactivation Date
24 January 2024
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience14
Completeness75
Years active:0State licenses:1Digital endpointsOther names

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Provider Addresses for Unknown Individual

  • 8023 SW 31 AV.

    PORTLAND, OR 972193708

    Phone: (503) 246-6743

    Type: Mailing

  • 19185, Southwest 90th Avenue, Arya at Hedges Creek, Tualatin, Metro, Washington County, Oregon, 97062, United States

    TUALATIN, OR 970627558

    Phone: (503) 885-7300

    Fax: (503) 885-7373

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

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Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

No Medicare enrollment or revalidation data available for this provider in our database.

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Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 97219)

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Reviews

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Frequently asked questions

What is the standard ID for Unknown Individual in the U.S.?
In the U.S., Unknown Individual is identified by NPI 1417039900.
Does inactive mean outdated data for Unknown Individual?
Inactive status means the NPI record is not marked active in the public file — verify before making care decisions.
How should patients interpret Unknown Individual's specialty?
The extract shows Mental Health Counselor for Unknown Individual. Clinical services aligned with this taxonomy classification.
What city is tied to Unknown Individual?
The directory associates Unknown Individual with Portland, Oregon. Check all listed addresses for suites or satellite offices.
Who maintains Unknown Individual's record?
Providers certify NPPES data; CMS hosts the public file you are viewing.

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