Unknown Individual – Family Medicine Physician, NPI 1083657282

Unknown Individual is a healthcare provider. based in Cle elum, Washington. specializing in Family Medicine Physician. They hold a License No. MD00015703 (WA). The NPI Number for Unknown Individual is 1083657282

Main info

Organization
Inactive
Name
Unknown Individual
NPI
1083657282
Phone
(509) 674-5331
Address
201 Alpha Way
Deactivation Date
20 December 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

  • 201 Alpha Way

    Cle Elum, WA 989221045

    Phone: (509) 674-5331

    Fax: (509) 674-5034

    Type: Location

  • 501, South 5th Avenue, Yakima, Yakima County, Washington, 98902, United States

    YAKIMA, WA 989023550

    Phone: (509) 494-6700

    Fax: (509) 573-6275

    Type: Mailing

  • East Mountain View Avenue, Ellensburg, Kittitas County, Washington, 98926, United States

    ELLENSBURG, WA 989263865

    Phone: (509) 962-1414

    Fax: (509) 962-1408

    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.

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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 98922)

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Reviews

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Frequently asked questions

How is Unknown Individual identified in CMS data?
CMS-hosted NPPES data lists Unknown Individual with NPI 1083657282.
Why is Unknown Individual marked inactive in the NPI directory?
The public NPI listing for Unknown Individual is not currently active; confirm directly with the practice or licensing boards.
What is Unknown Individual's primary classification?
Family Medicine Physician is the headline specialty for Unknown Individual here. Clinical services aligned with this taxonomy classification.
Where should I expect Unknown Individual on a map?
Expect Cle Elum, Washington as a primary anchor for Unknown Individual unless the record lists multiple sites.
Why does Unknown Individual have multiple addresses?
3 practice locations appear in the available data. Multiple addresses are common for hospital privileges, telehealth, or multi-site groups.

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