Provider Demographics
NPI:1457149940
Name:JIAO, HONGGUAN
Entity type:Individual
Prefix:
First Name:HONGGUAN
Middle Name:
Last Name:JIAO
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6888 ELM ST STE 2A
Mailing Address - Street 2:
Mailing Address - City:MC LEAN
Mailing Address - State:VA
Mailing Address - Zip Code:22101-3829
Mailing Address - Country:US
Mailing Address - Phone:571-207-6789
Mailing Address - Fax:
Practice Address - Street 1:6888 ELM ST STE 2A
Practice Address - Street 2:
Practice Address - City:MC LEAN
Practice Address - State:VA
Practice Address - Zip Code:22101-3829
Practice Address - Country:US
Practice Address - Phone:571-207-6789
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-04-25
Last Update Date:2025-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0121000825171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist