Individual
WHITNI NICOLE FRIBERG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PAC
Contact information
Practice address
3181 SW SAM JACKSON PARK RD, PORTLAND, OR 97239-3011
(503) 494-8311
Mailing address
3181 SW SAM JACKSON PARK RD, PORTLAND, OR 97239-3011
(503) 494-8311
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
PA175241
OR
363AM0700X
Medical Physician Assistant
Primary
PA175421
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2054614
—
WA
05
—
500699226
—
OR
Enumeration date
10/27/2014
Last updated
04/10/2025
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