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Avantika Saleen

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 Avantika Saleen 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
1699336503
Provider Type
Individual
Full Name
Saleen, Avantika
Title
Mrs.
Credential
PA-C

Gender
Female
Sole Proprietor
No
Enumeration Date
6/23/2019
Last Updated
7/19/2022

Contact Information

Practice Location

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

(503) 494-3442

(503) 494-5330

Mailing Location

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

(503) 494-3442

(503) 494-5330

Provider Taxonomies

Code	Description	License
Code 363AM0700X Primary	Description Physician Assistant Physician Assistants & Advanced Practice Nursing Providers	License PA210565 Oregon
Code 208M00000X	Description Hospitalist Allopathic & Osteopathic Physicians	License PA13399 Texas
Code 390200000X	Description Student in an Organized Health Care Education/Training Program Student, Health Care	License Unlisted Issuer

Avantika Saleen

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Code

Description

License

Code

Description

License

Locicero, Stephanie

Eure, Ann Elizabeth

Moredock, Maria Grompe

Myers, Jeffrey

Barwood, Gwen Lynn

Hill, Anya

Ahmad, Zoha

Ordway, Emma Claire

Bernstein, Juliana Mogielnicki

Fillman, Reid Wilder