Healthcare Provider Details

I. General information

NPI: 1790431716
Provider Name (Legal Business Name): I-HUI ELLEN LIU L.AC.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/28/2022
Last Update Date: 01/11/2023
Certification Date: 01/11/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5295 NE ELAM YOUNG PKWY STE 160
HILLSBORO OR
97124-7573
US

IV. Provider business mailing address

515 NW SALTZMAN RD # 783
PORTLAND OR
97229-6098
US

V. Phone/Fax

Practice location:
  • Phone: 503-844-4325
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License NumberAC208821
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: