Provider Demographics
NPI:1861594145
Name:CHE, XIA (DAOM, LAC)
Entity type:Individual
Prefix:
First Name:XIA
Middle Name:
Last Name:CHE
Suffix:
Gender:F
Credentials:DAOM, LAC
Other - Prefix:
Other - First Name:XIA
Other - Middle Name:
Other - Last Name:CHE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:13225 44TH AVE W
Mailing Address - Street 2:
Mailing Address - City:MUKILTEO
Mailing Address - State:WA
Mailing Address - Zip Code:98275-5907
Mailing Address - Country:US
Mailing Address - Phone:626-592-0910
Mailing Address - Fax:
Practice Address - Street 1:7935 216TH ST SW STE E
Practice Address - Street 2:
Practice Address - City:EDMONDS
Practice Address - State:WA
Practice Address - Zip Code:98026-7941
Practice Address - Country:US
Practice Address - Phone:425-672-2113
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-05
Last Update Date:2019-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA10682171100000X
171100000X
WA60237167171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA2138032Medicaid