Provider Demographics
NPI:1932720976
Name:BLAIR, XIAO PING Q (MASSAGE THERAPIST)
Entity Type:Individual
Prefix:
First Name:XIAO PING
Middle Name:Q
Last Name:BLAIR
Suffix:
Gender:F
Credentials:MASSAGE THERAPIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3880 COMMERCIAL ST SE # 201
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:OR
Mailing Address - Zip Code:97302-3835
Mailing Address - Country:US
Mailing Address - Phone:971-240-7880
Mailing Address - Fax:503-296-5849
Practice Address - Street 1:3880 COMMERCIAL ST SE # 201
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:OR
Practice Address - Zip Code:97302-3835
Practice Address - Country:US
Practice Address - Phone:971-240-7880
Practice Address - Fax:503-296-5849
Is Sole Proprietor?:Yes
Enumeration Date:2020-04-30
Last Update Date:2020-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR18999225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR18999OtherOREGON BOARD OF MASSAGE THERAPY