Unknown Individual – Clinical Psychologist, NPI 1053302539

Unknown Individual is a healthcare provider. based in Bellevue, Washington. specializing in Clinical Psychologist. They hold a License No. PY247 (WA). The NPI Number for Unknown Individual is 1053302539

Main info

Organization
Inactive
Name
Unknown Individual
NPI
1053302539
Phone
(425) 885-6444
Address
13436 NE 47TH ST
Deactivation Date
7 May 2026
Data current as of
3 June 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

  • South 47th Street, Bellevue, Sarpy County, Nebraska, 68157, United States

    BELLEVUE, WA 980051112

    Phone: (425) 885-6444

    Fax: (425) 881-7767

    Type: Mailing

  • Whole Foods Market, 1001, Broadway, First Hill, Seattle, King County, Washington, 98122, United States

    STE 318

    SEATTLE, WA 981224397

    Phone: (206) 726-0174

    Fax: (425) 881-7767

    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.

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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 98005)

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Reviews

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Frequently asked questions

Can I verify Unknown Individual with an NPI only?
You can start verification with NPI 1053302539 for Unknown Individual, then check state licensing separately.
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.
What address line appears for Unknown Individual?
Unknown Individual's geographic hint is Bellevue, Washington in our summary view.
How many locations tie to this NPI?
2 practice locations appear in the available data.

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