Provider Demographics
NPI:1396860920
Name:CLINIC FOR NATURAL & CHINESE MEDICINE
Entity Type:Organization
Organization Name:CLINIC FOR NATURAL & CHINESE MEDICINE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JIEYI
Authorized Official - Middle Name:
Authorized Official - Last Name:ZHANG
Authorized Official - Suffix:
Authorized Official - Credentials:ND, L,AC,
Authorized Official - Phone:503-649-8645
Mailing Address - Street 1:17949 SW TUALATIN VALLEY HWY.
Mailing Address - Street 2:
Mailing Address - City:BEAVERTON
Mailing Address - State:OR
Mailing Address - Zip Code:97003
Mailing Address - Country:US
Mailing Address - Phone:503-649-8645
Mailing Address - Fax:503-649-5473
Practice Address - Street 1:17949 SW TUALATIN VALLEY HWY.
Practice Address - Street 2:
Practice Address - City:BEAVERTON
Practice Address - State:OR
Practice Address - Zip Code:97003
Practice Address - Country:US
Practice Address - Phone:503-649-8645
Practice Address - Fax:503-649-5473
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-20
Last Update Date:2014-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORAC00669171100000X
OR1171175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes175F00000XOther Service ProvidersNaturopathGroup - Multi-Specialty
No171100000XOther Service ProvidersAcupuncturistGroup - Multi-Specialty