Unknown Individual – Emergency Medicine Physician, NPI 1396712964

Unknown Individual is a healthcare provider. based in Bellingham, Washington. specializing in Emergency Medicine Physician. They hold a License No. 26194 (WA). The NPI Number for Unknown Individual is 1396712964

Main info

Organization
Inactive
Name
Unknown Individual
NPI
1396712964
Phone
(360) 733-8286
Address
612 CLARK RD
Deactivation Date
7 February 2024
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

  • Clark Road, Edgemoor, Fairhaven, Bellingham, Whatcom County, Washington, 98262, United States

    BELLINGHAM, WA 982257842

    Phone: (360) 733-8286

    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.

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 98225)

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Reviews

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Frequently asked questions

How do payers reference Unknown Individual?
For Unknown Individual, use NPI 1396712964 as the unique 10-digit identifier.
Who updates status for Unknown Individual?
NPPES shows Unknown Individual as inactive; dates on the record explain the timeline when available.
What area of care is associated with Unknown Individual?
Unknown Individual's record emphasizes Emergency Medicine Physician. Clinical services aligned with this taxonomy classification.
Is Unknown Individual associated with Bellingham?
Public fields place Unknown Individual around Bellingham, Washington. Always confirm the exact site before visiting.
Does inactive status remove historical data?
Historical rows can remain visible after status changes — read the dates carefully.

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