Provider Demographics
NPI:1174797690
Name:CHEN'S ACUPUNCTURE CENTER, P.C.
Entity type:Organization
Organization Name:CHEN'S ACUPUNCTURE CENTER, P.C.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:FANG
Authorized Official - Middle Name:KUN
Authorized Official - Last Name:CHEN
Authorized Official - Suffix:
Authorized Official - Credentials:LAC, LMT
Authorized Official - Phone:503-255-2618
Mailing Address - Street 1:3620 NE 122ND AVE
Mailing Address - Street 2:SUITE D
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97230-1365
Mailing Address - Country:US
Mailing Address - Phone:503-255-2618
Mailing Address - Fax:
Practice Address - Street 1:3620 NE 122ND AVE
Practice Address - Street 2:SUITE D
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97230-1365
Practice Address - Country:US
Practice Address - Phone:503-255-2618
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-16
Last Update Date:2008-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORAC00346171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Multi-Specialty