Provider Demographics
NPI:1154416568
Name:PINCHES, SANDRA KAY (PHD)
Entity type:Individual
Prefix:DR
First Name:SANDRA
Middle Name:KAY
Last Name:PINCHES
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:P.O. BOX 19251
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97280-0251
Mailing Address - Country:US
Mailing Address - Phone:503-452-8306
Mailing Address - Fax:
Practice Address - Street 1:10175 SW BARBUR BLVD.
Practice Address - Street 2:SUITE 300BD
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97219-5909
Practice Address - Country:US
Practice Address - Phone:503-452-8306
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-03
Last Update Date:2011-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR439103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
ORR154837Medicare PIN