Healthcare Provider Details

I. General information

NPI: 1720906340
Provider Name (Legal Business Name): MINGJUN XIE
Entity Type: Individual
Gender:
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/09/2026
Last Update Date: 07/09/2026
Certification Date: 07/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1950 KEENE RD BLDG K
RICHLAND WA
99352-7752
US

IV. Provider business mailing address

1950 KEENE RD BLDG K
RICHLAND WA
99352-7752
US

V. Phone/Fax

Practice location:
  • Phone: 509-903-6618
  • Fax: 866-915-9696
Mailing address:
  • Phone: 509-903-6618
  • Fax: 866-915-9696

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License NumberACUP.AC.70125282
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: