Healthcare Provider Details

I. General information

NPI: 1306448725
Provider Name (Legal Business Name): SHIJIE GUO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/10/2020
Last Update Date: 06/08/2026
Certification Date: 06/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9709 3RD AVE NE
SEATTLE WA
98115-2062
US

IV. Provider business mailing address

7600 EVERGREEN WAY
EVERETT WA
98203-6421
US

V. Phone/Fax

Practice location:
  • Phone: 206-972-5836
  • Fax:
Mailing address:
  • Phone: 206-860-5414
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number347595
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number814045
License Number StateNY
# 3
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberAP61338025
License Number StateWA
# 4
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN61334294
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: