Provider Demographics
NPI:1720086168
Name:TSIKTSIRIS, LOUIE E (MD)
Entity Type:Individual
Prefix:
First Name:LOUIE
Middle Name:E
Last Name:TSIKTSIRIS
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:PO BOX 5127
Mailing Address - Street 2:
Mailing Address - City:EVERETT
Mailing Address - State:WA
Mailing Address - Zip Code:98206-5127
Mailing Address - Country:US
Mailing Address - Phone:425-339-5445
Mailing Address - Fax:425-303-3097
Practice Address - Street 1:3901 HOYT AVE
Practice Address - Street 2:
Practice Address - City:EVERETT
Practice Address - State:WA
Practice Address - Zip Code:98201-4918
Practice Address - Country:US
Practice Address - Phone:425-339-5445
Practice Address - Fax:425-303-3097
Is Sole Proprietor?:No
Enumeration Date:2005-07-11
Last Update Date:2021-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC200101504207RR0500X
WAMD60614080207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC89130H7Medicaid
WA2056359Medicaid
NC2297653Medicare ID - Type Unspecified
WA2056359Medicaid
WAG8954705Medicare PIN