Provider Demographics
NPI:1427896695
Name:CHAVEZ GUILLEN, ALEJANDRA IVETTE (CRM)
Entity type:Individual
Prefix:
First Name:ALEJANDRA
Middle Name:IVETTE
Last Name:CHAVEZ GUILLEN
Suffix:
Gender:F
Credentials:CRM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:944 W 5TH AVE
Mailing Address - Street 2:
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97402-5106
Mailing Address - Country:US
Mailing Address - Phone:541-687-2667
Mailing Address - Fax:541-284-2139
Practice Address - Street 1:944 W 5TH AVE
Practice Address - Street 2:
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97402-5106
Practice Address - Country:US
Practice Address - Phone:541-687-2667
Practice Address - Fax:541-284-2139
Is Sole Proprietor?:No
Enumeration Date:2024-07-19
Last Update Date:2024-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR24-CRM3194175T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist