Provider Demographics
NPI:1750548137
Name:DONG HUA ACUPUNCTURE AND HERBAL CLINIC
Entity type:Organization
Organization Name:DONG HUA ACUPUNCTURE AND HERBAL CLINIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DAOM, LAC
Authorized Official - Prefix:
Authorized Official - First Name:LI LI
Authorized Official - Middle Name:
Authorized Official - Last Name:ZHENG
Authorized Official - Suffix:
Authorized Official - Credentials:DAOM, LAC
Authorized Official - Phone:503-819-7944
Mailing Address - Street 1:12778 SE STARK ST
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97233-1539
Mailing Address - Country:US
Mailing Address - Phone:503-819-7944
Mailing Address - Fax:503-844-4195
Practice Address - Street 1:2110 NE CORNELL RD
Practice Address - Street 2:A
Practice Address - City:HILLSBORO
Practice Address - State:OR
Practice Address - Zip Code:97124-5985
Practice Address - Country:US
Practice Address - Phone:503-844-2715
Practice Address - Fax:503-844-4195
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-22
Last Update Date:2008-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORAC00670305R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes305R00000XManaged Care OrganizationsPreferred Provider Organization