Provider Demographics
NPI:1982657227
Name:JANOUT, MAREK (MD)
Entity type:Individual
Prefix:DR
First Name:MAREK
Middle Name:
Last Name:JANOUT
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 1:825 SE BISHOP BLVD STE 401
Mailing Address - Street 2:
Mailing Address - City:PULLMAN
Mailing Address - State:WA
Mailing Address - Zip Code:99163-5517
Mailing Address - Country:US
Mailing Address - Phone:509-336-7577
Mailing Address - Fax:509-715-2126
Practice Address - Street 1:825 SE BISHOP BLVD STE 401
Practice Address - Street 2:
Practice Address - City:PULLMAN
Practice Address - State:WA
Practice Address - Zip Code:99163-5517
Practice Address - Country:US
Practice Address - Phone:509-336-7577
Practice Address - Fax:509-715-2126
Is Sole Proprietor?:No
Enumeration Date:2006-05-18
Last Update Date:2023-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD00045341207RC0000X
IDM-9816207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA1023698Medicaid
ID807233700Medicaid