Provider Demographics
NPI:1831842970
Name:OERTEL, XIONGJIAO (LMT)
Entity type:Individual
Prefix:MS
First Name:XIONGJIAO
Middle Name:
Last Name:OERTEL
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5708 MEDALLION CT
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:VA
Mailing Address - Zip Code:22303-1050
Mailing Address - Country:US
Mailing Address - Phone:703-231-8953
Mailing Address - Fax:
Practice Address - Street 1:6118 FRANCONIA RD STE 210A
Practice Address - Street 2:
Practice Address - City:ALEXANDRIA
Practice Address - State:VA
Practice Address - Zip Code:22310-2565
Practice Address - Country:US
Practice Address - Phone:703-924-6288
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-01-29
Last Update Date:2022-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0019014550225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist