Individual
CHAVA SANDOVAL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
5050 NE HOYT ST STE 610, PORTLAND, OR 97213-2985
(503) 467-4761
Mailing address
PO BOX 622, HALFWAY, OR 97834-0622
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
194638
OR
Other
Enumeration date
04/30/2019
Last updated
02/17/2020
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