Provider Demographics
NPI:1093915258
Name:ZHOU, XIAO (LAC)
Entity Type:Individual
Prefix:
First Name:XIAO
Middle Name:
Last Name:ZHOU
Suffix:
Gender:M
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4220 SW 110TH AVE
Mailing Address - Street 2:
Mailing Address - City:BEAVERTON
Mailing Address - State:OR
Mailing Address - Zip Code:97005-3015
Mailing Address - Country:US
Mailing Address - Phone:503-646-7788
Mailing Address - Fax:
Practice Address - Street 1:4220 SW 110TH AVE
Practice Address - Street 2:
Practice Address - City:BEAVERTON
Practice Address - State:OR
Practice Address - Zip Code:97005-3015
Practice Address - Country:US
Practice Address - Phone:503-646-7788
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-07-24
Last Update Date:2007-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORAC00245171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist