Provider Demographics
NPI:1033115381
Name:GUO, FUHUA HOLLY (MD)
Entity Type:Individual
Prefix:DR
First Name:FUHUA
Middle Name:HOLLY
Last Name:GUO
Suffix:
Gender:F
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 873175
Mailing Address - Street 2:
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98687-3175
Mailing Address - Country:US
Mailing Address - Phone:360-798-5152
Mailing Address - Fax:360-326-9299
Practice Address - Street 1:513 N MORRISON RD
Practice Address - Street 2:
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98664-1432
Practice Address - Country:US
Practice Address - Phone:360-558-3068
Practice Address - Fax:360-326-9299
Is Sole Proprietor?:No
Enumeration Date:2005-06-22
Last Update Date:2022-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD00040178207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA1119262Medicaid
WAH52118Medicare UPIN
WA8800802Medicare ID - Type Unspecified