Provider Demographics
NPI:1720553845
Name:HUANG, XIAOYUAN
Entity Type:Individual
Prefix:
First Name:XIAOYUAN
Middle Name:
Last Name:HUANG
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1455 COLUMBIA PARK TRL
Mailing Address - Street 2:
Mailing Address - City:RICHLAND
Mailing Address - State:WA
Mailing Address - Zip Code:99352-4721
Mailing Address - Country:US
Mailing Address - Phone:509-396-3707
Mailing Address - Fax:509-396-3710
Practice Address - Street 1:1455 COLUMBIA PARK TRL
Practice Address - Street 2:
Practice Address - City:RICHLAND
Practice Address - State:WA
Practice Address - Zip Code:99352-4721
Practice Address - Country:US
Practice Address - Phone:509-396-3707
Practice Address - Fax:509-396-3710
Is Sole Proprietor?:No
Enumeration Date:2018-10-04
Last Update Date:2018-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAC60526948171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist