Provider Demographics
NPI:1467753475
Name:FU, YI
Entity Type:Individual
Prefix:MR
First Name:YI
Middle Name:
Last Name:FU
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15486 NW ENERGIA ST
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97229-8949
Mailing Address - Country:US
Mailing Address - Phone:503-484-4125
Mailing Address - Fax:503-617-0957
Practice Address - Street 1:12555 SW 1ST ST
Practice Address - Street 2:
Practice Address - City:BEAVERTON
Practice Address - State:OR
Practice Address - Zip Code:97005-0546
Practice Address - Country:US
Practice Address - Phone:503-887-2658
Practice Address - Fax:503-617-0957
Is Sole Proprietor?:Yes
Enumeration Date:2010-11-07
Last Update Date:2010-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORAC01265171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist