Provider Demographics
NPI:1306448725
Name:GUO, SHIJIE
Entity type:Individual
Prefix:
First Name:SHIJIE
Middle Name:
Last Name:GUO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1209 WESTLAKE AVE N UNIT 727
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98109-4881
Mailing Address - Country:US
Mailing Address - Phone:206-972-5836
Mailing Address - Fax:
Practice Address - Street 1:9709 3RD AVE NE
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98115-2062
Practice Address - Country:US
Practice Address - Phone:206-972-5836
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-11-10
Last Update Date:2024-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY814045163W00000X
WARN61334294163W00000X
NY347595363LF0000X, 363LF0000X
WAAP61338025363L00000X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163W00000XNursing Service ProvidersRegistered Nurse
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily