Provider Demographics
NPI:1346613270
Name:KOU, YUQING (LAC)
Entity Type:Individual
Prefix:
First Name:YUQING
Middle Name:
Last Name:KOU
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:725 NE 102ND AVE STE A
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97220-4065
Mailing Address - Country:US
Mailing Address - Phone:503-261-9603
Mailing Address - Fax:
Practice Address - Street 1:725 NE 102ND AVE STE A
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97220-4065
Practice Address - Country:US
Practice Address - Phone:503-261-9603
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-10-30
Last Update Date:2015-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORAC174535171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist