Individual
TAIPING JIA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
7100 SW FIR LOOP # 205, TIGARD, OR 97223-8022
(503) 475-9657
Mailing address
5677 BONITA RD, LAKE OSWEGO, OR 97035-3217
(503) 475-9657
Taxonomy
Speciality
Code
Description
License number
State
171100000X
Acupuncturist
Primary
AC00654
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
8236501
DRIVER LICENSE
OR
Enumeration date
07/01/2020
Last updated
07/01/2020
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