Dena Freed, CHW

Individual provider Active NPI Community Health Worker · Bandon, OR

NPI 1184456469 · NPPES record last updated Aug 15, 2024

Key facts

NPI
1184456469
Entity type
Individual (NPI type 1)
Primary specialty
Community Health Worker 172V00000X
License
111886 (OR)
Practice address
1010 1St St SE
Bandon, OR 97411-9301
Phone
(541) 347-2529
Fax
(541) 347-9196
NPI assigned
Aug 15, 2024
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
111886ORMDCommunity Health Worker

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Community Health Worker 172V00000X 111886 OR Yes

Addresses

Primary practice location

1010 1St St SE
Bandon, OR 97411-9301

Mailing address

1115 2ND St SE Apt 7
Bandon, OR 97411-9417
Phone (541) 290-7287

Other practice location 1

1312 Tichenor St
Port Orford, OR 97465-8776
Phone (541) 347-2529 ext. 335

Other providers in Bandon, OR

All providers in Bandon, OR · Community Health Worker in Oregon

Sources for this page

Verify at the official NPI Registry.