Provider Demographics
NPI:1649613175
Name:WANG, JAMES CHUNG HUAN (ND, LAC)
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:CHUNG HUAN
Last Name:WANG
Suffix:
Gender:M
Credentials:ND, LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3376 SE POWELL BLVD
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97202-1974
Mailing Address - Country:US
Mailing Address - Phone:971-888-4138
Mailing Address - Fax:
Practice Address - Street 1:3376 SE POWELL BLVD
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97202-1974
Practice Address - Country:US
Practice Address - Phone:971-888-4138
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-04-15
Last Update Date:2014-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORAC159673171100000X
OR1958175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist
No175F00000XOther Service ProvidersNaturopath