Healthcare Provider Details

I. General information

NPI: 1033827449
Provider Name (Legal Business Name): LIN XU
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/14/2022
Last Update Date: 04/24/2026
Certification Date: 04/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

901 N BRUTSCHER ST STE 208
NEWBERG OR
97132-6097
US

IV. Provider business mailing address

1083 N PACIFIC HWY
WOODBURN OR
97071-3732
US

V. Phone/Fax

Practice location:
  • Phone: 503-538-0100
  • Fax: 205-964-1913
Mailing address:
  • Phone: 425-659-0770
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number26774
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: