Healthcare Provider Details

I. General information

NPI: 1144726167
Provider Name (Legal Business Name): XIAO-YUE HAN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/30/2018
Last Update Date: 01/25/2026
Certification Date: 01/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1501 NE MEDICAL CENTER DR
BEND OR
97701-6051
US

IV. Provider business mailing address

1501 NE MEDICAL CENTER DR
BEND OR
97701-6051
US

V. Phone/Fax

Practice location:
  • Phone: 541-382-4900
  • Fax:
Mailing address:
  • Phone: 541-382-4900
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License NumberMD205655
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: