Healthcare Provider Details
I. General information
NPI: 1205746278
Provider Name (Legal Business Name): BAIHUI ACUPUNCTURE & HERBS LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 09/10/2026
Last Update Date: 09/10/2026
Certification Date: 09/10/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
12923 NW CORNELL RD STE 102
PORTLAND OR
97229-5834
US
IV. Provider business mailing address
12923 NW CORNELL RD STE 102
PORTLAND OR
97229-5834
US
V. Phone/Fax
- Phone: 971-430-6850
- Fax:
- Phone: 971-430-6850
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 171100000X |
| Taxonomy | Acupuncturist |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
KARIMA
JOHNSON
Title or Position: OWNER
Credential:
Phone: 971-430-6850