Provider Demographics
NPI:1972822948
Name:VAN ENK, JIAN (LAC, PHD)
Entity Type:Individual
Prefix:MS
First Name:JIAN
Middle Name:
Last Name:VAN ENK
Suffix:
Gender:F
Credentials:LAC, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2185 GREENVIEW ST
Mailing Address - Street 2:
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97401-2393
Mailing Address - Country:US
Mailing Address - Phone:805-574-0434
Mailing Address - Fax:
Practice Address - Street 1:460 COBURG RD
Practice Address - Street 2:SUITE 306
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97401-5531
Practice Address - Country:US
Practice Address - Phone:541-334-5000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-05-28
Last Update Date:2014-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC13499171100000X
ORAC162789171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist