Basic Information
| Provider Information | |||||||||
| NPI: | 1205157757 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | MITCHELL SANCHEZ | ||||||||
| FirstName: | MAILYNN | ||||||||
| MiddleName: | ALEXIS | ||||||||
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| Credential: | DO | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2073 OLYMPIC ST | ||||||||
| Address2: | |||||||||
| City: | SPRINGFIELD | ||||||||
| State: | OR | ||||||||
| PostalCode: | 974773413 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5416823550 | ||||||||
| FaxNumber: | 5416823551 | ||||||||
| Practice Location | |||||||||
| Address1: | 860 BELTLINE RD | ||||||||
| Address2: | |||||||||
| City: | SPRINGFIELD | ||||||||
| State: | OR | ||||||||
| PostalCode: | 974771091 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5412226005 | ||||||||
| FaxNumber: | 5412226029 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/18/2010 | ||||||||
| LastUpdateDate: | 09/20/2018 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | P1363 | TX | N | Allopathic & Osteopathic Physicians | Family Medicine | 207Q00000X | DO178919 | OR | Y | Allopathic & Osteopathic Physicians | Family Medicine |
No ID Information.