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Whitni Nicole Friberg

Physician Assistant

Physician Assistants & Advanced Practice Nursing Providers

3181 SW Sam Jackson Park Rd, Portland, OR 97239-3011

PECOS Enrollment

This provider is enrolled in PECOS as WHITNI FRIBERG.

Based on the most recent information from CMS, provider Whitni Nicole Friberg is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.

Part B
Medicare Part B
Enrolled
HHA
Home Health Agency
Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Enrolled

CMS last updated its PECOS records 3 days ago.

Profile Details

Provider ID
1346645843
Provider Type
Individual
Full Name
Friberg, Whitni Nicole
Credential
PAC

Gender
Female
Sole Proprietor
No
Enumeration Date
10/27/2014
Last Updated
4/10/2025

Contact Information

Practice Location

3181 SW Sam Jackson Park Rd, Portland, OR 97239-3011

(503) 494-8311

Unlisted Fax

Mailing Location

3181 SW Sam Jackson Park Rd, Portland, OR 97239-3011

(503) 494-8311

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 363AM0700X Primary	Description Physician Assistant Physician Assistants & Advanced Practice Nursing Providers	License PA175421 Oregon
Code 363A00000X	Description Physician Assistant Physician Assistants & Advanced Practice Nursing Providers	License PA175241 Oregon

Provider Identifiers

ID	Description	Issuer
ID 2054614	Description Medicaid	Issuer Unlisted Washington
ID 500699226	Description Medicaid	Issuer Unlisted Oregon

Whitni Nicole Friberg

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Code

Description

License

Provider Identifiers

ID

Description

Issuer

ID

Description

Issuer

ID

Description

Issuer

Walter, Molly Ann

Taylor, Anne Miriam

Crawford Rowe, Elizabeth Kay

Ying, Monique M

Spencer, Mary Ellen

Weis, Nicole

Makarachi, Teardaad

Dang, Theresa Huong Tuyet Thi

Atwood, Ashley

Myers, Robert A