Healthcare Provider Details

I. General information

NPI: 1215808530
Provider Name (Legal Business Name): XIN XIANG RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/17/2025
Last Update Date: 09/17/2025
Certification Date: 09/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2600 PRINGLE RD SE
SALEM OR
97302-1557
US

IV. Provider business mailing address

17232 OAKDALE RD
DALLAS OR
97338-9653
US

V. Phone/Fax

Practice location:
  • Phone: 503-385-4675
  • Fax: 503-363-0061
Mailing address:
  • Phone: 503-385-4675
  • Fax: 503-363-0061

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WS0200X
TaxonomySchool Registered Nurse
License Number099000626RN
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: