Healthcare Provider Details

I. General information

NPI: 1780151027
Provider Name (Legal Business Name): WEI GUO, DMD,MD,PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/25/2018
Last Update Date: 03/08/2021
Certification Date: 03/08/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2111 N NORTHGATE WAY STE 105
SEATTLE WA
98133-9018
US

IV. Provider business mailing address

2111 N NORTHGATE WAY STE 105
SEATTLE WA
98133-9018
US

V. Phone/Fax

Practice location:
  • Phone: 206-365-6860
  • Fax:
Mailing address:
  • Phone: 425-301-9609
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223S0112X
TaxonomyOral and Maxillofacial Surgery (Dentist)
License Number
License Number State

VIII. Authorized Official

Name: DR. WEI GUO
Title or Position: PRESIDENT
Credential: DMD,MD
Phone: 253-838-3223