Healthcare Provider Details

I. General information

NPI: 1720144793
Provider Name (Legal Business Name): SARAH BETH CHANDLER DNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/27/2006
Last Update Date: 01/15/2025
Certification Date: 01/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

932 W IDAHO AVE STE 100
ONTARIO OR
97914-2155
US

IV. Provider business mailing address

660 E FRANKLIN RD STE 140
MERIDIAN ID
83642-2914
US

V. Phone/Fax

Practice location:
  • Phone: 541-889-2244
  • Fax: 541-889-2626
Mailing address:
  • Phone: 208-992-2672
  • Fax: 208-992-2673

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LG0600X
TaxonomyGerontology Nurse Practitioner
License Number71650
License Number StateID
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number45817
License Number StateID
# 3
Primary TaxonomyN
Taxonomy Code163WC0200X
TaxonomyCritical Care Medicine Registered Nurse
License Number9220812
License Number StateFL
# 4
Primary TaxonomyN
Taxonomy Code363LG0600X
TaxonomyGerontology Nurse Practitioner
License Number10000570
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: