Unknown Individual – Occupational Therapist, NPI 1902920424

Unknown Individual is a healthcare provider. based in Portland, Oregon. specializing in Occupational Therapist. They hold a License No. 01006140 (OR). The NPI Number for Unknown Individual is 1902920424

Main info

Organization
Inactive
Name
Unknown Individual
NPI
1902920424
Phone
(503) 962-1900
Address
909 SW 18th Ave
Deactivation Date
21 November 2024

Contacts

Secure Messaging
shedrickpark110783@oc.providencedirect.org
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience19
Completeness85
Years active:0State licenses:1Other namesUpdated within 12 months

Provider Addresses for Unknown Individual

  • 909 SW 18th Ave

    Portland, OR 972051705

    Phone: (503) 962-1900

    Fax: (503) 962-1925

    Type: Location

  • 820 NW 12TH AVE

    # 310

    PORTLAND, OR 972093042

    Phone: (503) 267-0481

    Type: Mailing

  • 909 SW 18TH AVE

    PORTLAND, OR 972051705

    Phone: (503) 962-1900

    Fax: (503) 962-1925

    Type: Location

  • PO BOX 3158

    PORTLAND, OR 972083158

    Phone: (503) 215-6494

    Type: Mailing

  • 12345 SW HORIZON BLVD STE 57

    BEAVERTON, OR 970079475

    Phone: (503) 216-8625

    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 97205)

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Reviews

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Frequently asked questions

Is Unknown Individual listed with a National Provider Identifier?
Yes — Unknown Individual has NPI 1902920424 on file in the registry.
Is inactive the same as retired for Unknown Individual?
Inactive registry status can reflect deactivation, consolidation, or data lag.
What expertise is attributed to Unknown Individual?
Unknown Individual's specialty line reads Occupational Therapist. Clinical services aligned with this taxonomy classification.
What practice footprint exists for Unknown Individual?
Travel planning: use Portland, Oregon as the reference point for Unknown Individual, then confirm.
What does 5 location(s) imply?
5 practice locations appear in the available data.