MEDICARE: MR. GREGORY LOUIE PT, DPT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2251X0800X	Orthopedic Physical Therapist	60815331	WA

General Provider Information

NPI Number	:	1114427044
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. GREGORY LOUIE PT, DPT

Provider Business Mailing Address
First Line	:	1560 140TH AVE NE STE 100
Second Line	:
City	:	BELLEVUE
State	:	WA
Zip	:	98005-4571
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3200 W MCGRAW ST
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98199-3208
Country	:	US
Telephone Number	:	206-281-7970
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/16/2018
Last Update Date	:	02/16/2018

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