Unknown Individual – Optometrist, NPI 1710074430

Unknown Individual is a healthcare provider. based in Federal way, Washington. specializing in Optometrist. They hold a License No. 1168 (WA). The NPI Number for Unknown Individual is 1710074430

Main info

Organization
Inactive
Name
Unknown Individual
NPI
1710074430
Phone
(253) 839-1028
Address
1025 S 320TH ST
Deactivation Date
7 August 2024
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience19
Completeness75
Years active:0State licenses:1Digital endpointsOther names

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Provider Addresses for Unknown Individual

  • Centennial Office Building, 1025, South 320th Street, Federal Way, King County, Washington, 98003, United States

    SUITE 105

    FEDERAL WAY, WA 980035358

    Phone: (253) 839-1028

    Fax: (253) 839-1029

    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 98003)

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Provider's Procedures

Unknown Individual performs procedures in Optometrist. See the list of HCPCS codes below.
SpecialtyPractice State
HCPCS Code
Description
Service Count
Beneficiary Count
OPTOMETRYWA92083Measurement of field of vision during daylight conditions1513

Reviews

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Frequently asked questions

How do I look up Unknown Individual by NPI?
Use NPI 1710074430 when you need to reference Unknown Individual in forms, claims, or directories.
Why would Unknown Individual's listing show inactive?
Inactive in NPPES means the identifier is not currently active in that dataset.
What field does Unknown Individual work in?
You can think of Unknown Individual as practicing within Optometrist. Clinical services aligned with this taxonomy classification.
What location shows for Unknown Individual?
We surface Federal Way, Washington for Unknown Individual based on available NPPES addresses.
How can I contact Unknown Individual?
Phone or fax may appear on the official NPI record when supplied — verify before relying on them.

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