Unknown Individual – Anesthesiology Physician, NPI 1477557965

Unknown Individual is a healthcare provider. based in Lakewood, Washington. specializing in Anesthesiology Physician. They hold a License No. MD00026484 (WA). The NPI Number for Unknown Individual is 1477557965

Main info

Organization
Inactive
Name
Unknown Individual
NPI
1477557965
Phone
(253) 588-7911
Address
PO BOX 97115
Deactivation Date
31 August 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

  • PO BOX 97115

    LAKEWOOD, WA 984970115

    Phone: (253) 588-7911

    Type: Mailing

  • Mottman Road Southwest, Breckenridge Heights, Tumwater, Thurston County, Washington, 98512, United States

    STE B

    TUMWATER, WA 985127833

    Phone: (360) 754-5858

    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.

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 98497)

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Reviews

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Frequently asked questions

How do I look up Unknown Individual by NPI?
Use NPI 1477557965 when you need to reference Unknown Individual in forms, claims, or directories.
How do I interpret inactive records for Unknown Individual?
Treat inactive as a signal to verify Unknown Individual through official channels.
What field does Unknown Individual work in?
You can think of Unknown Individual as practicing within Anesthesiology Physician. Clinical services aligned with this taxonomy classification.
What location shows for Unknown Individual?
We surface Lakewood, Washington for Unknown Individual based on available NPPES addresses.
Does Medicare enrollment show here?
Medicare enrollment screens are separate from the basic NPI extract shown here.

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