Unknown Individual – Pediatric Nurse Practitioner, NPI 1770530305

Unknown Individual is a healthcare provider. based in Puyallup, Washington. specializing in Pediatric Nurse Practitioner. They hold a License No. AP30000776 (WA). The NPI Number for Unknown Individual is 1770530305

Main info

Organization
Inactive
Name
Unknown Individual
NPI
1770530305
Phone
(253) 697-5502
Address
PO BOX 40
Deactivation Date
2 June 2021
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 40

    PUYALLUP, WA 983710137

    Phone: (253) 697-5502

    Fax: (253) 697-5510

    Type: Mailing

  • New Hope Lutheran Church, 603, 3rd Avenue Southeast, Pacific, King County, Washington, 98047, United States

    PACIFIC, WA 980471431

    Phone: (253) 351-0450

    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 98371)

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Reviews

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Frequently asked questions

Can I verify Unknown Individual with an NPI only?
You can start verification with NPI 1770530305 for Unknown Individual, then check state licensing separately.
Is Unknown Individual's NPI deactivated?
The extract indicates Unknown Individual is not in an active NPI state.
What is Unknown Individual best known for clinically?
Directory data describes Unknown Individual with Pediatric Nurse Practitioner. Clinical services aligned with this taxonomy classification.
Does Unknown Individual list a practice location?
Patients near Puyallup, Washington may find Unknown Individual in results; validate coverage separately.
Is the information about Unknown Individual up to date?
Data updates when providers file changes in NPPES — treat critical facts as "verify if unsure."

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