Healthcare Provider Details

I. General information

NPI: 1346438504
Provider Name (Legal Business Name): SALMA FARIS PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/11/2007
Last Update Date: 09/19/2025
Certification Date: 09/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4655 SW GRIFFITH DR STE 120
BEAVERTON OR
97005-8729
US

IV. Provider business mailing address

11842 SE REDHAWKS LN
HAPPY VALLEY OR
97086-6705
US

V. Phone/Fax

Practice location:
  • Phone: 971-439-2345
  • Fax: 971-439-2346
Mailing address:
  • Phone: 610-360-7392
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License NumberPA01276
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: