Unknown Individual – Clinical Psychologist, NPI 1013012129

Unknown Individual is a healthcare provider. based in Edmonds, Washington. specializing in Clinical Psychologist. They hold a License No. PY00003560 (WA). The NPI Number for Unknown Individual is 1013012129

Main info

Organization
Inactive
Name
Unknown Individual
NPI
1013012129
Phone
(425) 744-1750
Address
21701 76TH AVE W
Deactivation Date
12 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

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Provider Addresses for Unknown Individual

  • 21701, 76th Avenue West, Perrinville, Edmonds, Snohomish County, Washington, 98026, United States of America

    SUITE #306

    EDMONDS, WA 980267536

    Phone: (425) 744-1750

    Fax: (425) 744-1751

    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 98026)

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Reviews

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Frequently asked questions

What is the 10-digit NPI for Unknown Individual?
Unknown Individual — NPI 1013012129 — is the standard way to identify this listing.
What dates should I check for Unknown Individual's activity?
We display what the registry publishes: Unknown Individual appears inactive there.
What is Unknown Individual's primary classification?
Clinical Psychologist is the headline specialty for Unknown Individual here. Clinical services aligned with this taxonomy classification.
Where is Unknown Individual based?
Unknown Individual is tied to Edmonds, Washington in the data we show; additional addresses may exist on the full record.
How many locations tie to this NPI?
2 practice locations appear in the available data.

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