Provider Demographics
NPI:1639886575
Name:TAN, MARCUS GUORUI (MD, FAAD, FRCPC)
Entity type:Individual
Prefix:DR
First Name:MARCUS
Middle Name:GUORUI
Last Name:TAN
Suffix:
Gender:
Credentials:MD, FAAD, FRCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:660 SW 39TH ST STE 150
Mailing Address - Street 2:
Mailing Address - City:RENTON
Mailing Address - State:WA
Mailing Address - Zip Code:98057-4912
Mailing Address - Country:US
Mailing Address - Phone:425-690-3483
Mailing Address - Fax:425-690-9083
Practice Address - Street 1:660 SW 39TH ST STE 150
Practice Address - Street 2:
Practice Address - City:RENTON
Practice Address - State:WA
Practice Address - Zip Code:98057-4912
Practice Address - Country:US
Practice Address - Phone:425-690-3483
Practice Address - Fax:425-690-9083
Is Sole Proprietor?:No
Enumeration Date:2022-10-31
Last Update Date:2025-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD61647325207N00000X, 207ND0101X
TXT7371207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ND0101XAllopathic & Osteopathic PhysiciansDermatologyMOHS-Micrographic Surgery
No207N00000XAllopathic & Osteopathic PhysiciansDermatology