Provider Demographics
NPI:1609635697
Name:XIE, XIAO LIN (L AC, EAMP)
Entity Type:Individual
Prefix:
First Name:XIAO
Middle Name:LIN
Last Name:XIE
Suffix:
Gender:F
Credentials:L AC, EAMP
Other - Prefix:
Other - First Name:SELINE
Other - Middle Name:
Other - Last Name:XIE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:L AC, EAMP
Mailing Address - Street 1:11448 SE 82ND ST
Mailing Address - Street 2:
Mailing Address - City:NEWCASTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98056-1646
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3901 NE 4TH ST STE 111
Practice Address - Street 2:
Practice Address - City:RENTON
Practice Address - State:WA
Practice Address - Zip Code:98056-4100
Practice Address - Country:US
Practice Address - Phone:425-686-9580
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-03-13
Last Update Date:2024-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAC61527099171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist