Unknown Individual – Pediatrics Physician, NPI 1861790438

Pediatrics Physician

Unknown Individual is a healthcare provider. based in Port orchard, Washington. specializing in Pediatrics Physician. They hold a License No. 16679 (IA). The NPI Number for Unknown Individual is 1861790438

Main info

Organization

Inactive

Name

Unknown Individual

NPI

1861790438

Phone

(360) 871-2219

Address

5355 CRANE AVE E

Deactivation Date

8 November 2022

Data current as of

20 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

5355 CRANE AVE E
PORT ORCHARD, WA 983668000
Phone: (360) 871-2219
Fax: (360) 871-4436
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 98366)

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Reviews

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Frequently asked questions

What is the registry number for Unknown Individual?

The registry entry for Unknown Individual shows NPI 1861790438.

What should I verify if Unknown Individual is listed inactive?

If Unknown Individual looks inactive here, cross-check state licensing and the clinic website.

What does the directory say Unknown Individual does?

Insurance directories may phrase it differently, but here Unknown Individual maps to Pediatrics Physician. Clinical services aligned with this taxonomy classification.

Can patients visit Unknown Individual in Port Orchard, Washington?

For routing, start with Port Orchard, Washington for Unknown Individual, then verify phone and hours locally.

Who maintains Unknown Individual's record?

Providers certify NPPES data; CMS hosts the public file you are viewing.