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General NPI Number Information
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NPI Number | 1427765270
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Entity Type | Individual
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Provider Name | XIANG JI L.AC
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Gender | Male
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Dates
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Enumeration Date | 11/01/2022
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Last Update Date | 11/01/2022
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Provider Practice Location Address
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Address Line | 2305 SE WASHINGTON ST STE 110
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City | MILWAUKIE
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State | OR
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Zip | 97222-7647
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Country | US
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Telephone | 559-745-5030
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Fax |
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Provider Business Mailing Address
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Address Line | 12135 SE 31ST PL APT 31
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City | MILWAUKIE
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State | OR
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Zip | 97222-6869
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Country | US
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Telephone | 715-497-4778
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171100000X
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Taxonomy Name | Acupuncturist
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License Number | AC209352
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License Number State | OR
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