Provider Demographics
NPI:1134981749
Name:SANCHEZ, ALI MICHELLE (CHW, CRM, PSS,QMHAR)
Entity type:Individual
Prefix:
First Name:ALI
Middle Name:MICHELLE
Last Name:SANCHEZ
Suffix:
Gender:F
Credentials:CHW, CRM, PSS,QMHAR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:113 E 20TH AVE
Mailing Address - Street 2:
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97405-2903
Mailing Address - Country:US
Mailing Address - Phone:503-348-5957
Mailing Address - Fax:
Practice Address - Street 1:432 W 11TH AVE
Practice Address - Street 2:
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97401-3451
Practice Address - Country:US
Practice Address - Phone:541-682-4464
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-01-29
Last Update Date:2024-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORTHW000110044172V00000X, 175T00000X
171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
No172V00000XOther Service ProvidersCommunity Health Worker
No175T00000XOther Service ProvidersPeer Specialist