WHITNI NICOLE FRIBERG


Address: 1111 Ne 99th Ave, Portland, OR 97220-9428
Phone: 5039633030

WHITNI NICOLE FRIBERG (NPI# 1346645843) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1346645843
Entity Type Individual
Full Name WHITNI NICOLE FRIBERG
Credential PAC
Practice Address 1111 Ne 99th Ave
Portland
OR 97220-9428
Mailing Address 847 Ne 19th Ave
Suite 300
Portland
OR 97232-2684
Practice Telephone 5039633030
Practice Fax Number 5039633140
Mailing Telephone 5039632801
Mailing Fax Number 5039632825
Enumeration Date 2014-10-27
Last Update Date 2016-07-19
Gender Code F
Is Sole Proprietor Y

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 363AM0700X Physician Assistant
Specialization: Medical
PA175421 OR Physician Assistants & Advanced Practice Nursing Providers
N 390200000X Student in an Organized Health Care Education/Training Program Student, Health Care

Other Provider Identifier

State Issuer Identifier Type Code
OR 500699226 05
WA 2054614 05

Office Location

Street Address 1111 NE 99TH AVE
City PORTLAND
State OR
Zip Code 97220-9428

Providers in the same location

NPI Name Taxonomy Address Enumeration
1578568499 David Arthur Schroeder Internal Medicine 1111 Ne 99th Ave, Suite 201, Portland, OR 97220-9428 2005-06-16
1942788013 Stephanie Smith Physical Therapist 1111 Ne 99th Ave, Portland, OR 97220-9428 2018-08-01
1114405131 Robert Francis Graham Physical Therapist 1111 Ne 99th Ave, Portland, OR 97220-9428 2018-08-01
1962952655 Portland Gastroenterology Equipment Clinic/Center 1111 Ne 99th Ave, Suite 302, Portland, OR 97220-9428 2016-10-06
1346609534 Theresa Orazio Wear Nurse Practitioner 1111 Ne 99th Ave, Portland, OR 97220-9428 2016-02-16
1023483799 Alyssa Marie O'brien Dietitian, Registered 1111 Ne 99th Ave, Portland, OR 97220-9428 2015-12-07
1134504103 Ross Alan Vannorman Physician Assistant 1111 Ne 99th Ave, Portland, OR 97220-9428 2015-07-20
1558748293 Carly Jacqueline Griffin Nurse Practitioner 1111 Ne 99th Ave, Portland, OR 97220-9428 2015-05-01
1932507472 Amanda Vandeventer Physician Assistant 1111 Ne 99th Ave, Suite 201, Portland, OR 97220-9428 2014-12-16
1003217910 Cindy Fulton Physician Assistant 1111 Ne 99th Ave, Suite 201, Portland, OR 97220-9428 2014-09-10
Find all providers in the same location

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1316569254 Debra Shamblin Behavioral Analyst 150 Ne 100th Ave, Portland, OR 97220 2020-05-14
1336780618 Joan Lambert Technician 2802 Ne 108th Avenue, Portland, OR 97220 2019-10-08
1750933917 Multnomah County Clinic/Center 11540 Ne Inverness Dr., Inverness Jail, Portland, OR 97220 2019-07-09
1194223107 Landmark Connect of Oregon PC General Practice 5933 Ne Win Sivers Dr Ste 310, Portland, OR 97220 2018-01-24
1487178711 Andrew Shonk Massage Therapist 163 Ne 102nd Ave Blid V, Portland, OR 97220 2017-07-28
1548781693 Greater New Hope Family Services Lodging 11868 Ne Sandy Blvd, Portland, OR 97220 2017-06-29
1245771740 Maria Teresa Banez Salcedo Registered Nurse 10300 Ne Hancock Street, Portland, OR 97220 2017-03-16
1568901858 Christopher Gabriel Lyons Adult Companion 1343 Ne 118 Ave. Apt5, Portland, OR 97220 2017-02-20
1962945956 Linda Ann Oldenburg Registered Nurse 9515 Ne Skidmore Avenue, Portland, OR 97220 2016-11-23
1326493446 Trent D. Wilson Massage Therapist 8401 Ne Halsey St., Suite 101, Portland, OR 97220 2016-04-26
Find all providers in zip 97220

Taxonomy Information

Taxonomy Code 363AM0700X
Grouping Physician Assistants & Advanced Practice Nursing Providers
Classification Physician Assistant
Specialization Medical

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1073081428 Ishah Marie Price Physician Assistant 30 Preble St Apt 663, Portland, ME 04101-4939 2018-11-04
1740797166 Joseph Something Physician Assistant 4800 Sw 76th Ave, Portland, OR 97225-1804 2018-01-08
1235687013 Satchel Harry Physician Assistant 417 Sw 117th Ave Fl 2, Portland, OR 97225-5924 2016-09-21
1922551910 Ashley Crowell Physician Assistant 949 Nw Overton St Unit 306, Portland, OR 97209 2016-07-26
1871982975 Colin Storz Physician Assistant 3623 N Borthwick Ave, Portland, OR 97227-1218 2015-01-13
1275888729 Stephanie Calvin Physician Assistant 782 College St, Portland, TN 37148-2120 2012-07-20
1174800031 Carolyn Frances Farrell Physician Assistant 450 N Graham St, Portland, OR 97227-1682 2011-11-07
1316130198 Ronald W Kessler Physician Assistant 632 Brighton Ave, Portland, ME 04102-1017 2007-08-24
1124210778 Honey E.l. Marques Physician Assistant 16279 Se Division St, Portland, OR 97236-1971 2007-08-16
1124177902 Dmitriy Shore Physician Assistant 10305 Sw Park Way Ste 300, Portland, OR 97225-5033 2007-01-09
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Competitor

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City PORTLAND
Zip Code 97220

Improve Information

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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