Provider Demographics
NPI:1528266236
Name:LUO, YUNPENG (LAC)
Entity type:Individual
Prefix:
First Name:YUNPENG
Middle Name:
Last Name:LUO
Suffix:
Gender:M
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:5201 SW WESTGATE DR
Mailing Address - Street 2:SUITE 116
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97221-2412
Mailing Address - Country:US
Mailing Address - Phone:503-203-8898
Mailing Address - Fax:503-203-8809
Practice Address - Street 1:5201 SW WESTGATE DR
Practice Address - Street 2:SUITE 116
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97221-2412
Practice Address - Country:US
Practice Address - Phone:503-203-8898
Practice Address - Fax:503-203-8809
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORAC00650171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist