MEDICARE: CHERISA SANDROW D.O.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	0102208145	VA
2	207Q00000X	Family Medicine Physician	DO174412	OR
3	207Q00000X	Family Medicine Physician	OS013368	PA
4	207Q00000X	Family Medicine Physician	OP60001820	WA
5	207Q00000X	Family Medicine Physician	OS17251	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1568664944
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHERISA SANDROW D.O.

Provider Business Mailing Address
First Line	:	2514 NW AWBREY RD
Second Line	:
City	:	BEND
State	:	OR
Zip	:	97703-5536
Country	:	US
Telephone Number	:	503-407-9112
Fax Number	:

Provider Business Practice Location Address
First Line	:	2514 NW AWBREY RD
Second Line	:
City	:	BEND
State	:	OR
Zip	:	97703-5536
Country	:	US
Telephone Number	:	503-407-9112
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/05/2007
Last Update Date	:	03/10/2026

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Directions to “ CHERISA SANDROW D.O.” Practice Location

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