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General NPI Number Information
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NPI Number | 1568201846
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Entity Type | Individual
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Provider Name | AMY YAMEI GU OD
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Gender | Female
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Dates
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Enumeration Date | 05/24/2024
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Last Update Date | 10/20/2025
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Provider Practice Location Address
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Address Line | 18321 VETERANS MEMORIAL DR E
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City | BONNEY LAKE
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State | WA
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Zip | 98391-7147
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Country | US
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Telephone | 253-400-2128
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Fax | 253-561-7002
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Provider Business Mailing Address
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Address Line | 18321 VETERANS MEMORIAL DR E
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City | BONNEY LAKE
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State | WA
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Zip | 98391-7147
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Country | US
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Telephone | 253-400-2128
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Fax | 253-561-7002
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | OD61585652
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License Number State | WA
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