Unknown Individual – Cardiovascular Disease Physician, NPI 1235128653

Cardiovascular Disease Physician

Unknown Individual is a healthcare provider. based in Marysville, Washington. specializing in Cardiovascular Disease Physician. They hold a License No. MD00045680 (WA). The NPI Number for Unknown Individual is 1235128653

Main info

Organization

Inactive

Name

Unknown Individual

NPI

1235128653

Phone

(360) 653-3690

Address

12309 2ND DRIVE NE

Deactivation Date

11 November 2023

Data current as of

19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology

Experience36

Completeness75

Years active:0State licenses:4Digital endpointsOther names

Provider Addresses for Unknown Individual

12309 2ND DRIVE NE
MARYSVILLE, WA 98271
Phone: (360) 653-3690
Fax: (360) 336-2088
Type: Mailing
307 S 13TH ST STE 300
SUITE 300
MOUNT VERNON, WA 982744109
Phone: (360) 336-9757
Fax: (360) 336-2088
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 98271)

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Reviews

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Frequently asked questions

Can I use this page to confirm Unknown Individual's NPI?

Yes. Unknown Individual is listed with NPI 1235128653 in the public NPI dataset.

Why might Unknown Individual appear inactive while still practicing?

We display what the registry publishes: Unknown Individual appears inactive there.

What taxonomy line describes Unknown Individual?

For research purposes, treat Unknown Individual as Cardiovascular Disease Physician in this dataset. Clinical services aligned with this taxonomy classification.

Where should I expect Unknown Individual on a map?

Expect Marysville, Washington as a primary anchor for Unknown Individual unless the record lists multiple sites.

How many locations tie to this NPI?

2 practice locations appear in the available data.