Unknown Individual – Optometrist, NPI 1003835539

Unknown Individual is a healthcare provider. based in Puyallup, Washington. specializing in Optometrist. They hold a License No. 953 (WA). The NPI Number for Unknown Individual is 1003835539

Main info

Organization
Inactive
Name
Unknown Individual
NPI
1003835539
Phone
(253) 840-0780
Address
12914 130TH AVENUE CT E
Deactivation Date
26 June 2025
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

  • 12914 130TH AVENUE CT E

    PUYALLUP, WA 983744825

    Phone: (253) 840-0780

    Type: Mailing

  • OPTOMETRY CLINIC

    MADIGAN ARMY MEDICAL CENTER

    TACOMA, WA 984310001

    Phone: (253) 968-2790

    Fax: (253) 968-4677

    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 98374)

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Reviews

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Frequently asked questions

Where can patients find Unknown Individual's NPI?
You can confirm Unknown Individual with NPI 1003835539; it appears in the national provider directory.
Is Unknown Individual's inactive status permanent?
An inactive NPI does not by itself prove someone stopped practicing — check other sources.
What field does Unknown Individual work in?
You can think of Unknown Individual as practicing within Optometrist. Clinical services aligned with this taxonomy classification.
Where is Unknown Individual's primary listing?
We display Puyallup, Washington because that is what the record indicates for Unknown Individual.
Does Medicare enrollment show here?
Medicare enrollment screens are separate from the basic NPI extract shown here.

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