Provider Demographics
NPI:1922767565
Name:SANCHEZ, REGINA (CHW)
Entity Type:Individual
Prefix:
First Name:REGINA
Middle Name:
Last Name:SANCHEZ
Suffix:
Gender:F
Credentials:CHW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:61445 SE 27TH ST UNIT 50
Mailing Address - Street 2:
Mailing Address - City:BEND
Mailing Address - State:OR
Mailing Address - Zip Code:97702-9596
Mailing Address - Country:US
Mailing Address - Phone:541-771-0403
Mailing Address - Fax:
Practice Address - Street 1:2065 NE TUCSON WAY
Practice Address - Street 2:
Practice Address - City:BEND
Practice Address - State:OR
Practice Address - Zip Code:97701-5182
Practice Address - Country:US
Practice Address - Phone:541-383-3005
Practice Address - Fax:541-383-1883
Is Sole Proprietor?:Yes
Enumeration Date:2021-12-10
Last Update Date:2022-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR172V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker