Provider Demographics
NPI:1043394760
Name:GIANUTSOS, LOUIS P (MD)
Entity Type:Individual
Prefix:
First Name:LOUIS
Middle Name:P
Last Name:GIANUTSOS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12040 NE 128TH ST
Mailing Address - Street 2:MS-50
Mailing Address - City:KIRKLAND
Mailing Address - State:WA
Mailing Address - Zip Code:98034-3013
Mailing Address - Country:US
Mailing Address - Phone:425-899-1920
Mailing Address - Fax:425-899-1933
Practice Address - Street 1:7315 212TH ST SW STE 101
Practice Address - Street 2:
Practice Address - City:EDMONDS
Practice Address - State:WA
Practice Address - Zip Code:98026-7610
Practice Address - Country:US
Practice Address - Phone:425-775-9474
Practice Address - Fax:425-670-3554
Is Sole Proprietor?:No
Enumeration Date:2006-10-25
Last Update Date:2021-05-20
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
WAMD00032765207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine