Unknown Individual – Procedural Dermatology Physician, NPI 1215938808

Unknown Individual is a healthcare provider. based in Puyallup, Washington. specializing in Procedural Dermatology Physician. They hold a License No. MD00038522 (WA). The NPI Number for Unknown Individual is 1215938808

Main info

Organization
Inactive
Name
Unknown Individual
NPI
1215938808
Phone
(253) 841-2453
Address
929 E MAIN AVE
Deactivation Date
7 September 2022
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

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Provider Addresses for Unknown Individual

  • 929, East Main Avenue, Meeker, Puyallup, Pierce County, Washington, 98372, United States

    SUITE 210

    PUYALLUP, WA 983723116

    Phone: (253) 841-2453

    Fax: (253) 840-5519

    Mailing address matches the actual address.

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 98372)

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Reviews

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Frequently asked questions

Can I cross-check Unknown Individual using NPI 1215938808?
NPI 1215938808 belongs to Unknown Individual; compare other details if you need extra assurance.
Can Unknown Individual still bill if the NPI is inactive?
Do not rely on inactive status alone — contact the provider for confirmation.
What kind of doctor is Unknown Individual?
Unknown Individual is associated with Procedural Dermatology Physician in the directory — Clinical services aligned with this taxonomy classification.
Is Unknown Individual located near Puyallup?
Unknown Individual currently maps to Puyallup, Washington in this extract.
When was this NPI issued?
Enumeration for Unknown Individual is noted as not shown in this record where the registry provides it.

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