Provider Demographics
NPI:1144619768
Name:GIANNAKOPOULOS, ALEX (PHARMD)
Entity Type:Individual
Prefix:
First Name:ALEX
Middle Name:
Last Name:GIANNAKOPOULOS
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:210 GOVERNMENT RD
Mailing Address - Street 2:
Mailing Address - City:MATTAWA
Mailing Address - State:WA
Mailing Address - Zip Code:99349-5116
Mailing Address - Country:US
Mailing Address - Phone:509-932-4119
Mailing Address - Fax:509-932-4086
Practice Address - Street 1:210 GOVERNMENT RD
Practice Address - Street 2:
Practice Address - City:MATTAWA
Practice Address - State:WA
Practice Address - Zip Code:99349-5116
Practice Address - Country:US
Practice Address - Phone:509-932-4119
Practice Address - Fax:509-932-4086
Is Sole Proprietor?:Yes
Enumeration Date:2015-01-20
Last Update Date:2023-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA608670683336C0003X
WA60483365183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
No3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy