Unknown Individual – Physical Therapist, NPI 1720158546

Unknown Individual is a healthcare provider. based in Coos bay, Oregon. specializing in Physical Therapist. They hold a License No. 4173 (OR). The NPI Number for Unknown Individual is 1720158546

Main info

Organization
Inactive
Name
Unknown Individual
NPI
1720158546
Phone
(541) 892-2311
Address
63940 WALLACE RD
Deactivation Date
1 June 2021
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

Provider Addresses for Unknown Individual

  • 63940 WALLACE RD

    COOS BAY, OR 974208780

    Phone: (541) 892-2311

    Type: Mailing

  • 1775 THOMPSON AVE

    COOS BAY, OR 974208780

    Phone: (541) 892-2311

    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.

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.

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

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 97420)

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Reviews

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Frequently asked questions

How do I look up Unknown Individual by NPI?
Use NPI 1720158546 when you need to reference Unknown Individual in forms, claims, or directories.
How do I interpret inactive records for Unknown Individual?
Treat inactive as a signal to verify Unknown Individual through official channels.
What does Unknown Individual treat or focus on?
Patients typically see Unknown Individual under the specialty Physical Therapist. Clinical services aligned with this taxonomy classification.
What location shows for Unknown Individual?
We surface Coos Bay, Oregon for Unknown Individual based on available NPPES addresses.
What if Coos Bay, Oregon seems incomplete?
Street-level detail can be omitted — open the full address list for this NPI.

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