Provider Demographics
NPI:1447389408
Name:LU, CHIAOLI ANDREA (ND)
Entity Type:Individual
Prefix:
First Name:CHIAOLI
Middle Name:ANDREA
Last Name:LU
Suffix:
Gender:F
Credentials:ND
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10201 SE HOLGATE BLVD
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97266-2418
Mailing Address - Country:US
Mailing Address - Phone:503-762-1122
Mailing Address - Fax:503-762-1155
Practice Address - Street 1:10201 SE HOLGATE BLVD
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97266-2418
Practice Address - Country:US
Practice Address - Phone:503-762-1122
Practice Address - Fax:503-762-1155
Is Sole Proprietor?:No
Enumeration Date:2007-03-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORAC00914171100000X
OR1368175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered171100000XOther Service ProvidersAcupuncturist
Not Answered175F00000XOther Service ProvidersNaturopath