Provider Demographics
NPI:1477956944
Name:QIAN, ZHUOYUAN (DPT)
Entity Type:Individual
Prefix:
First Name:ZHUOYUAN
Middle Name:
Last Name:QIAN
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12836 SW INCLINE DR
Mailing Address - Street 2:
Mailing Address - City:BEAVERTON
Mailing Address - State:OR
Mailing Address - Zip Code:97007-3009
Mailing Address - Country:US
Mailing Address - Phone:917-396-8742
Mailing Address - Fax:
Practice Address - Street 1:11735 SW QUEEN ELIZABETH ST STE 103
Practice Address - Street 2:
Practice Address - City:KING CITY
Practice Address - State:OR
Practice Address - Zip Code:97224-2665
Practice Address - Country:US
Practice Address - Phone:503-941-5666
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-09-29
Last Update Date:2022-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARPT3885225100000X
OR62878225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist