Provider Demographics
NPI:1083597389
Name:CHIN, ANDREW WARREN (LAC)
Entity type:Individual
Prefix:MR
First Name:ANDREW
Middle Name:WARREN
Last Name:CHIN
Suffix:
Gender:M
Credentials:LAC
Other - Prefix:
Other - First Name:ERIN
Other - Middle Name:MELISSA HO
Other - Last Name:APPLEBY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2240 SE 182ND AVE
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97233
Mailing Address - Country:US
Mailing Address - Phone:503-335-9440
Mailing Address - Fax:503-493-7281
Practice Address - Street 1:2240 SE 182ND AVE
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97233
Practice Address - Country:US
Practice Address - Phone:503-335-9440
Practice Address - Fax:503-493-7281
Is Sole Proprietor?:No
Enumeration Date:2025-07-26
Last Update Date:2025-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORAC223075171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist