Healthcare Provider Details

I. General information

NPI: 1679127815
Provider Name (Legal Business Name): DOULAS LATINAS INTERNATIONAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/25/2019
Last Update Date: 04/05/2023
Certification Date: 04/05/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

620 NW 8TH ST
GRESHAM OR
97030-6935
US

IV. Provider business mailing address

620 NW 8TH ST
GRESHAM OR
97030-6935
US

V. Phone/Fax

Practice location:
  • Phone: 503-901-6285
  • Fax:
Mailing address:
  • Phone: 503-901-6285
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code374J00000X
TaxonomyDoula
License Number
License Number State

VIII. Authorized Official

Name: SANDRA HELENA HERNANDES
Title or Position: CEO
Credential:
Phone: 503-901-6285