Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Dr. Theodore C Koutlas, MD

Individual provider Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician · NPI 1902898331

Dr. Theodore C Koutlas, MD is a Cardiac Surgery in Spokane, Washington. Graduated from University of Washington School of Medicine in 1987, 39 years ago. Practices with Providence Health and Services-Wa, a 25-clinician group and accepts Medicare assignment. Licensed in Idaho, North Carolina and Washington.

Years since qualifying
39
Trained at
University of Washington School of Medicine
Licensed in
ID, NC, WA
In the registry since
2005
Specialties on file
3
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

62 W 7th Ave Ste 110
Spokane, WA 99204-2321
Phone: (509) 456-0262
Fax: (509) 462-5059
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician (primary) Taxonomy 208G00000X · Licence MD60367366 (WA)
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician Taxonomy 208G00000X · Licence M-12098 (ID)
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician Taxonomy 208G00000X · Licence 36754 (NC)

Record details

NPI number1902898331
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedAugust 22, 2005
Last updated in NPPESJune 16, 2021
Certification dateJune 16, 2021
Mailing address62 W 7th Ave Ste 110, Spokane, WA 99204-2321

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyCARDIAC SURGERY
Medical schoolUNIVERSITY OF WASHINGTON SCHOOL OF MEDICINE
Graduated 1987 (39 years in practice)
Group practice Providence Health And Services-Wa — 25 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

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