Provider Demographics
NPI:1649939463
Name:SANDOVAL-GARCIA, RAQUEL JAHNE (CNA, DSW, HHA, PSW)
Entity type:Individual
Prefix:
First Name:RAQUEL
Middle Name:JAHNE
Last Name:SANDOVAL-GARCIA
Suffix:
Gender:F
Credentials:CNA, DSW, HHA, PSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8413 SW MONICA CT
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97223-2109
Mailing Address - Country:US
Mailing Address - Phone:503-593-8421
Mailing Address - Fax:
Practice Address - Street 1:8422 NE 8TH WAY
Practice Address - Street 2:
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98664-1974
Practice Address - Country:US
Practice Address - Phone:360-256-2980
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-12-08
Last Update Date:2021-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker