Unknown Individual – Family Nurse Practitioner, NPI 1104811033

Unknown Individual is a healthcare provider. based in Spokane, Washington. specializing in Family Nurse Practitioner. They hold a License No. AP30005168 (WA). The NPI Number for Unknown Individual is 1104811033

Main info

Organization
Inactive
Name
Unknown Individual
NPI
1104811033
Phone
(509) 993-7192
Address
2614 E 39TH AVE
Deactivation Date
23 October 2025
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience24
Completeness75
Years active:0State licenses:1Digital endpointsOther names

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Provider Addresses for Unknown Individual

  • 2614, East 39th Avenue, Southgate, Spokane, Spokane County, Washington, 99223, United States

    SPOKANE, WA 992234541

    Phone: (509) 993-7192

    Type: Mailing

  • 123, West Cascade Way, Town and Country, Spokane County, Washington, 99208, United States

    SPOKANE, WA 992086017

    Phone: (509) 489-4581

    Fax: (509) 482-0717

    Type: Location

  • 107 S Division St

    Spokane, WA 992021510

    Phone: (509) 838-4651

    Fax: (509) 363-2762

    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 99223)

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Reviews

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Frequently asked questions

What federal number belongs to Unknown Individual?
The federal identifier for Unknown Individual is NPI 1104811033.
Why would Unknown Individual's listing show inactive?
Inactive in NPPES means the identifier is not currently active in that dataset.
What does Unknown Individual treat or focus on?
Patients typically see Unknown Individual under the specialty Family Nurse Practitioner. Clinical services aligned with this taxonomy classification.
What location metadata exists for Unknown Individual?
The page summarizes Spokane, Washington for Unknown Individual; expand the address list for detail.
How can I contact Unknown Individual?
Phone or fax may appear on the official NPI record when supplied — verify before relying on them.

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