Unknown Individual – Physician Assistant, NPI 1679761340

Unknown Individual is a healthcare provider. based in Omak, Washington. specializing in Physician Assistant. They hold a License No. PA10005218 (WA). The NPI Number for Unknown Individual is 1679761340

Main info

Organization
Inactive
Name
Unknown Individual
NPI
1679761340
Phone
(509) 826-1800
Address
916 KOALA AVE
Deactivation Date
12 July 2023
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

Provider Addresses for Unknown Individual

  • 916 KOALA AVE

    OMAK, WA 988419576

    Phone: (509) 826-1800

    Type: Location

  • Wenatchee Valley Medical Center, 820, North Chelan Avenue, Wenatchee, Chelan County, Washington, 98801, United States

    WENATCHEE, WA 988012028

    Phone: (509) 663-8711

    Type: Mailing

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

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 98841)

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Reviews

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Frequently asked questions

What is the 10-digit NPI for Unknown Individual?
Unknown Individual — NPI 1679761340 — is the standard way to identify this listing.
Is Unknown Individual's NPI deactivated?
The extract indicates Unknown Individual is not in an active NPI state.
What healthcare role does Unknown Individual hold?
Scheduling teams often label Unknown Individual under Physician Assistant. Clinical services aligned with this taxonomy classification.
What address line appears for Unknown Individual?
Unknown Individual's geographic hint is Omak, Washington in our summary view.
What does 'Individual Provider' mean on this profile?
Entity type tells you whether the number belongs to a person or an organization.

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