Unknown Individual – Case Manager/Care Coordinator, NPI 1104963669

Unknown Individual is a healthcare provider. based in Vancouver, Washington. specializing in Case Manager/Care Coordinator. The NPI Number for Unknown Individual is 1104963669

Main info

Organization
Inactive
Name
Unknown Individual
NPI
1104963669
Phone
(360) 256-6757
Address
4608 NW HARNEY ST
Deactivation Date
20 November 2020
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience10
Completeness75
Years active:0State licenses:0Digital endpointsOther names

Loading map...

Provider Addresses for Unknown Individual

  • 4608, Northwest Harney Street, Northwest, Vancouver, Clark County, Washington, 98663, United States

    VANCOUVER, WA 986631730

    Phone: (360) 256-6757

    Type: Mailing

  • 1232, Northwest 23rd Avenue, Nob Hill, Northwest District, Portland, Multnomah County, Oregon, 97210, United States

    PORTLAND, OR 972102906

    Phone: (503) 227-3450

    Fax: (503) 227-3612

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

Loading prescription activity...

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 98663)

Loading plans...

Reviews

All reviews are moderated before publication. Reviews reflect users' opinions; we do not verify the accuracy of individual reviews.

No reviews yet. Be the first to share your experience — your opinion helps families compare providers.

Frequently asked questions

Can I verify Unknown Individual with an NPI only?
You can start verification with NPI 1104963669 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 best known for clinically?
Directory data describes Unknown Individual with Case Manager/Care Coordinator. Clinical services aligned with this taxonomy classification.
What address line appears for Unknown Individual?
Unknown Individual's geographic hint is Vancouver, Washington in our summary view.
Why does Unknown Individual have multiple addresses?
2 practice locations appear in the available data. Multiple addresses are common for hospital privileges, telehealth, or multi-site groups.