Look up the most recent NPI and PECOS records

Amanda Jensen

Physician Assistant

Physician Assistants & Advanced Practice Nursing Providers

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

PECOS Enrollment

Based on the most recent information from CMS, provider Amanda Jensen 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
1417479759
Provider Type
Individual
Full Name
Jensen, Amanda
Credential
PA-C

Gender
Female
Sole Proprietor
Yes
Enumeration Date
7/7/2017
Last Updated
12/13/2023

Contact Information

Practice Location

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

(503) 494-8562

(503) 418-5505

Mailing Location

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

(503) 494-8562

(503) 418-5505

Provider Taxonomies

Code	Description	License
Code 363AM0700X Primary	Description Physician Assistant Physician Assistants & Advanced Practice Nursing Providers	License PA184481 Oregon
Code 363A00000X	Description Physician Assistant Physician Assistants & Advanced Practice Nursing Providers	License PA184481 Oregon

Amanda Jensen

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Code

Description

License

Spencer, Mary Ellen

Aby-Daniel, Diana

Barwood, Gwen Lynn

Wood, Ann Margaret

Mesa, Kendra D

Shears, Gayle Lauren

Fay, Shannon

Schulzetenberg, Briana

Lechich, Kirstie Macmillen

Mostafavifar, Mina