Healthcare Provider Details

I. General information

NPI: 1275462178
Provider Name (Legal Business Name): NANQIN XIE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/16/2026
Last Update Date: 05/16/2026
Certification Date: 05/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1030 NE COUCH ST
PORTLAND OR
97232-3067
US

IV. Provider business mailing address

14726 SE MAIN ST
PORTLAND OR
97233-2649
US

V. Phone/Fax

Practice location:
  • Phone: 503-335-9440
  • Fax:
Mailing address:
  • Phone: 571-898-6053
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License NumberAC228313
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: