Saleen D Manternach, MD

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

A84270 Issued in CA

Practice address

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

Phone

(503) 494-7008

Fax

(503) 494-4997

NPI assigned

Aug 1, 2006

Last updated

May 11, 2011By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other names 1

• Saleen D Dermenjian Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1154390400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1305072000000",
    "number": "1235146655",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "333 S STATE ST",
            "address_2": "STE V181",
            "city": "LAKE OSWEGO",
            "state": "OR",
            "postal_code": "970343932",
            "telephone_number": "559-970-9487"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3181 SW SAM JACKSON PARK RD",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972393011",
            "telephone_number": "503-494-7008",
            "fax_number": "503-494-4997"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANTERNACH",
        "first_name": "SALEEN",
        "middle_name": "D",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-01",
        "last_updated": "2011-05-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "CA",
            "license": "A84270",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SALEEN",
            "last_name": "DERMENJIAN",
            "middle_name": "D",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Katie Mansour, FNP
• Sydney A Mansour, DMD
• Timothy W. Mansour, M.D.
• Elissa Kathleen Mantalas, MA
• Elliott Joel Mantell, D.C.
• Richard C Manthey, MD
• Melinda Mae Mantooth, DO
• Manual Medicine & Rehabilitation Center PC, of Wa (Dr. Ibolit)
• Manual Medicine and Rehabilitation, PC
• Lexi Manuel, PA-C

• Emergency Medicine Physician in Portland, OR
• Providers in Portland, OR by specialty
• Emergency Medicine Physician in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 11, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.