Provider Demographics
NPI:1861815516
Name:SANTOS, LOUIE JAMES NUYDA (PT)
Entity Type:Individual
Prefix:MR
First Name:LOUIE JAMES
Middle Name:NUYDA
Last Name:SANTOS
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3782 LOLO PASS WAY NE
Mailing Address - Street 2:APT 203
Mailing Address - City:SALEM
Mailing Address - State:OR
Mailing Address - Zip Code:97305-3985
Mailing Address - Country:US
Mailing Address - Phone:971-312-8027
Mailing Address - Fax:
Practice Address - Street 1:3782 LOLO PASS WAY NE
Practice Address - Street 2:APT 203
Practice Address - City:SALEM
Practice Address - State:OR
Practice Address - Zip Code:97305-3985
Practice Address - Country:US
Practice Address - Phone:971-312-8027
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-01-31
Last Update Date:2014-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR60378225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist