Unknown Individual – Physician Assistant, NPI 1760490320

Unknown Individual is a healthcare provider. based in Seattle, Washington. specializing in Physician Assistant. They hold a License No. PA60055301 (WA). The NPI Number for Unknown Individual is 1760490320

Main info

Organization
Inactive
Name
Unknown Individual
NPI
1760490320
Phone
(206) 417-0326
Address
12721 30th Ave NE
Deactivation Date
11 November 2023

Contacts

SOAP Endpoint
https://careepicwa.kp.org:14430/Interconnect-CE-PRD/wcf/epic.community.hie/xcpdrespondinggatewaysync
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience23
Completeness85
Years active:0State licenses:2Other namesUpdated within 12 months

Provider Addresses for Unknown Individual

  • 12721 30th Ave NE

    Suite101

    Seattle, WA 981254498

    Phone: (206) 417-0326

    Fax: (206) 417-0783

    Type: Location

  • 20200 54TH AVE W

    LYNNWOOD, WA 980366318

    Phone: (425) 672-6400

    Type: Mailing

  • 12721, 30th Avenue Northeast, Kenwood, Lake City, Seattle, King County, Washington, 98125, United States

    SUITE 101

    SEATTLE, WA 981254498

    Phone: (206) 417-0326

    Fax: (206) 417-0783

    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.

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 98125)

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Reviews

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Frequently asked questions

Can I cross-check Unknown Individual using NPI 1760490320?
NPI 1760490320 belongs to Unknown Individual; compare other details if you need extra assurance.
Is inactive the same as retired for Unknown Individual?
Inactive registry status can reflect deactivation, consolidation, or data lag.
What expertise is attributed to Unknown Individual?
Unknown Individual's specialty line reads Physician Assistant. Clinical services aligned with this taxonomy classification.
What practice footprint exists for Unknown Individual?
Travel planning: use Seattle, Washington as the reference point for Unknown Individual, then confirm.
When was this NPI issued?
Enumeration for Unknown Individual is noted as not shown in this record where the registry provides it.

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