Healthcare Provider Details

I. General information

NPI: 1861342941
Provider Name (Legal Business Name): HARRIET SANDERS CHW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/29/2026
Last Update Date: 01/29/2026
Certification Date: 01/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2450 SW PERKINS AVE
PENDLETON OR
97801-4302
US

IV. Provider business mailing address

904 SW DORION AVE
PENDLETON OR
97801-1936
US

V. Phone/Fax

Practice location:
  • Phone: 541-276-1700
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code172V00000X
TaxonomyCommunity Health Worker
License Number114114
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: