Healthcare Provider Details

I. General information

NPI: 1487517207
Provider Name (Legal Business Name): BAOXIN CHENG
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/08/2025
Last Update Date: 12/08/2025
Certification Date: 12/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1827 NE 44TH AVE STE 310
PORTLAND OR
97213-1468
US

IV. Provider business mailing address

5515 NW PACIFIC RIM BLVD APT 322
CAMAS WA
98607-8874
US

V. Phone/Fax

Practice location:
  • Phone: 503-320-7136
  • Fax: 503-776-7719
Mailing address:
  • Phone: 206-397-6328
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberR12436
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: