Healthcare Provider Details

I. General information

NPI: 1275279481
Provider Name (Legal Business Name): ANNIE ZE-PING HSU LAC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/10/2022
Last Update Date: 05/10/2022
Certification Date: 05/10/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4160 NE SANDY BLVD # 1100
PORTLAND OR
97212-5336
US

IV. Provider business mailing address

4160 NE SANDY BLVD # 1100
PORTLAND OR
97212-5336
US

V. Phone/Fax

Practice location:
  • Phone: 503-249-9000
  • Fax:
Mailing address:
  • Phone: 503-249-9000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License NumberAC209922
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: