Provider Demographics
NPI:1275274656
Name:GU, TIANHUA (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:TIANHUA
Middle Name:
Last Name:GU
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:DR
Other - First Name:TED
Other - Middle Name:
Other - Last Name:GU
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:18800 NW ROCK CREEK CIR APT 197
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97229-7219
Mailing Address - Country:US
Mailing Address - Phone:909-569-2267
Mailing Address - Fax:
Practice Address - Street 1:11190 SW BARNES RD
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97225-5372
Practice Address - Country:US
Practice Address - Phone:503-526-9121
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-04-07
Last Update Date:2022-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORRPH-0018482183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
ORRPH-0018482OtherOREGON PHARMACIST LICENSE