Provider Demographics
NPI:1710014501
Name:CHEN, XIAOLI (LAC)
Entity Type:Individual
Prefix:
First Name:XIAOLI
Middle Name:
Last Name:CHEN
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2945 SE 81ST AVE
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97206-1751
Mailing Address - Country:US
Mailing Address - Phone:503-274-0532
Mailing Address - Fax:503-274-0532
Practice Address - Street 1:2232 NW PETTYGROVE ST
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97210-2608
Practice Address - Country:US
Practice Address - Phone:503-552-1552
Practice Address - Fax:503-827-8460
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORAC00893171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist