Unknown Individual – Psychologist, NPI 1639179575

Unknown Individual is a healthcare provider. based in Grants pass, Oregon. specializing in Psychologist. They hold a License No. MD12754 (OR). The NPI Number for Unknown Individual is 1639179575

Main info

Organization
Inactive
Name
Unknown Individual
NPI
1639179575
Phone
(541) 476-6881
Address
243 NE C ST
Deactivation Date
14 December 2022
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

  • 243, Northeast C Street, Grants Pass, Josephine County, Oregon, 97526, United States

    GRANTS PASS, OR 975262153

    Phone: (541) 476-6881

    Fax: (541) 955-8410

    Mailing address matches the actual address.

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.

This can happen when there are no reportable CMS Open Payments records.

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 97526)

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Reviews

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Frequently asked questions

What identifier follows Unknown Individual across health systems?
The NPI 1639179575 uniquely identifies Unknown Individual in U.S. healthcare data.
What happens when Unknown Individual's NPI is not active?
Public data lists Unknown Individual outside the active bucket for this identifier.
How should patients interpret Unknown Individual's specialty?
The extract shows Psychologist for Unknown Individual. Clinical services aligned with this taxonomy classification.
What geographic area is tied to Unknown Individual?
Unknown Individual is associated with Grants Pass, Oregon in the same public data insurers reference.
What is the difference between NPI and a medical license?
An NPI is a federal identifier; a medical license is issued by a state and governs where someone may practice.

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