Provider Demographics
NPI:1952635971
Name:GUO, WEIQUN (OD)
Entity Type:Individual
Prefix:
First Name:WEIQUN
Middle Name:
Last Name:GUO
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 1:381 STRANDER BLVD
Mailing Address - Street 2:
Mailing Address - City:TUKWILA
Mailing Address - State:WA
Mailing Address - Zip Code:98188-2916
Mailing Address - Country:US
Mailing Address - Phone:206-575-6166
Mailing Address - Fax:206-575-6949
Practice Address - Street 1:381 STRANDER BLVD
Practice Address - Street 2:
Practice Address - City:TUKWILA
Practice Address - State:WA
Practice Address - Zip Code:98188-2916
Practice Address - Country:US
Practice Address - Phone:206-575-6166
Practice Address - Fax:206-575-6949
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-23
Last Update Date:2016-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA60101535152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist