Provider Demographics
NPI:1376150003
Name:GUAN, YUEYING (OD)
Entity Type:Individual
Prefix:
First Name:YUEYING
Middle Name:
Last Name:GUAN
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14645 NE BEL RED RD STE 102
Mailing Address - Street 2:
Mailing Address - City:BELLEVUE
Mailing Address - State:WA
Mailing Address - Zip Code:98007-3929
Mailing Address - Country:US
Mailing Address - Phone:425-442-1542
Mailing Address - Fax:425-747-2099
Practice Address - Street 1:14645 NE BEL RED RD STE 102
Practice Address - Street 2:
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98007-3929
Practice Address - Country:US
Practice Address - Phone:425-747-2020
Practice Address - Fax:425-747-2099
Is Sole Proprietor?:No
Enumeration Date:2020-09-27
Last Update Date:2023-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA61240274152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA61240274OtherLICENSE
WAG9042771OtherMEDICARE