Provider Demographics
NPI:1669934386
Name:FU, TIANYUAN (MD)
Entity type:Individual
Prefix:DR
First Name:TIANYUAN
Middle Name:
Last Name:FU
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:GEORGE
Other - Middle Name:
Other - Last Name:FU
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:925 SENECA ST
Mailing Address - Street 2:H8-GME
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98101
Mailing Address - Country:US
Mailing Address - Phone:206-583-6079
Mailing Address - Fax:
Practice Address - Street 1:925 SENECA ST
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98101-2742
Practice Address - Country:US
Practice Address - Phone:206-583-6079
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-04-02
Last Update Date:2019-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training ProgramGroup - Single Specialty