Provider Demographics
NPI:1033115381
Name:GUO, FUHUA HOLLY (MD)
Entity type:Individual
Prefix:DR
First Name:FUHUA
Middle Name:HOLLY
Last Name:GUO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:515 SE 200TH PL
Mailing Address - Street 2:
Mailing Address - City:CAMAS
Mailing Address - State:WA
Mailing Address - Zip Code:98607-8610
Mailing Address - Country:US
Mailing Address - Phone:360-798-5152
Mailing Address - Fax:
Practice Address - Street 1:1601 E 4TH PLAIN BLVD OFC
Practice Address - Street 2:
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98661-3713
Practice Address - Country:US
Practice Address - Phone:360-759-1901
Practice Address - Fax:360-759-1685
Is Sole Proprietor?:No
Enumeration Date:2005-06-22
Last Update Date:2025-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD00040178207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA1119262Medicaid
WAH52118Medicare UPIN
WA8800802Medicare ID - Type Unspecified