Unknown Individual – Physician Assistant, NPI 1124090899

Unknown Individual is a healthcare provider. based in Bremerton, Washington. specializing in Physician Assistant. They hold a License No. PA10004897 (WA). The NPI Number for Unknown Individual is 1124090899

Main info

Organization
Inactive
Name
Unknown Individual
NPI
1124090899
Phone
(360) 478-2366
Address
PO BOX 960
Deactivation Date
28 August 2024
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience28
Completeness75
Years active:0State licenses:2Digital endpointsOther names

Provider Addresses for Unknown Individual

  • PO BOX 960

    BREMERTON, WA 98337

    Phone: (360) 478-2366

    Fax: (360) 373-2096

    Type: Mailing

  • 616 SIXTH ST

    PENINSULA COMMUNITY HEALTH SERVICES

    BREMERTON, WA 98337

    Phone: (360) 377-3776

    Fax: (360) 479-0038

    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

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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 98337)

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Reviews

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Frequently asked questions

Can I cross-check Unknown Individual using NPI 1124090899?
NPI 1124090899 belongs to Unknown Individual; compare other details if you need extra assurance.
Is Unknown Individual still active if the NPI shows inactive?
NPPES shows Unknown Individual as inactive; dates on the record explain the timeline when available.
What expertise is attributed to Unknown Individual?
Unknown Individual's specialty line reads Physician Assistant. Clinical services aligned with this taxonomy classification.
What locale is associated with Unknown Individual?
Directory geography for Unknown Individual centers on Bremerton, Washington.
Does inactive status remove historical data?
Historical rows can remain visible after status changes — read the dates carefully.

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