NPC names can only show letters, so anything else in the name will not show up in-game and is purely for reference in the DB or to allow 2 NPCs to have the same name in-game, but different names for quest scripts.
The #s were probably started from the collects of Live that included them. Many named NPCs and other invisible NPCs started with a #, so they are still that way in our DB. Personally, I like to set my nameds to all use a # in front so it is easier to see what is what when I look at a zone worth of spawns.
The numbers and underscores are basically the same idea. They don't necessarily mean anything in all cases, but in some cases they may be important (if they have a script tied to them).
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