Provider Demographics
NPI:1437578051
Name:MALAKOUTI, NAVID DAVID (MD)
Entity Type:Individual
Prefix:
First Name:NAVID
Middle Name:DAVID
Last Name:MALAKOUTI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:2041 GEORGIA AVE NW
Mailing Address - Street 2:STE 2107
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20060-0001
Mailing Address - Country:US
Mailing Address - Phone:202-865-6725
Mailing Address - Fax:202-865-1757
Practice Address - Street 1:15906 MILL CREEK BLVD
Practice Address - Street 2:
Practice Address - City:MILL CREEK
Practice Address - State:WA
Practice Address - Zip Code:98012-1797
Practice Address - Country:US
Practice Address - Phone:425-385-2009
Practice Address - Fax:425-939-0807
Is Sole Proprietor?:No
Enumeration Date:2014-04-10
Last Update Date:2020-01-29
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WAMD60916736207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology