Provider Demographics
NPI:1750493953
Name:XUE, YUFANG (LAC, DIPLCH)
Entity Type:Individual
Prefix:
First Name:YUFANG
Middle Name:
Last Name:XUE
Suffix:
Gender:M
Credentials:LAC, DIPLCH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:337 NE 5TH AVE
Mailing Address - Street 2:
Mailing Address - City:CAMAS
Mailing Address - State:WA
Mailing Address - Zip Code:98607-2030
Mailing Address - Country:US
Mailing Address - Phone:360-798-7132
Mailing Address - Fax:
Practice Address - Street 1:337 NE 5TH AVE
Practice Address - Street 2:
Practice Address - City:CAMAS
Practice Address - State:WA
Practice Address - Zip Code:98607-2030
Practice Address - Country:US
Practice Address - Phone:360-798-7132
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-01
Last Update Date:2012-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAC00002853171100000X
ORAC00880171100000X
MN1235171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist
Provider Identifiers
StateIdentifier IDID TypeIssuer
20576OtherCHINESE HERBOLOGY