Provider Demographics
NPI:1114034436
Name:SALAZAR-COLLET, ROSARIO EMILIA (MHS,PA(ASCP))
Entity Type:Individual
Prefix:MRS
First Name:ROSARIO
Middle Name:EMILIA
Last Name:SALAZAR-COLLET
Suffix:
Gender:F
Credentials:MHS,PA(ASCP)
Other - Prefix:MRS
Other - First Name:ROSARIO
Other - Middle Name:EMILIA
Other - Last Name:SALAZAR
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:14415 SE 119TH AVE
Mailing Address - Street 2:
Mailing Address - City:CLACKAMAS
Mailing Address - State:OR
Mailing Address - Zip Code:97015-7217
Mailing Address - Country:US
Mailing Address - Phone:503-698-3565
Mailing Address - Fax:
Practice Address - Street 1:13705 NE AIRPORT WAY
Practice Address - Street 2:SUITE C
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97230-1048
Practice Address - Country:US
Practice Address - Phone:503-258-6800
Practice Address - Fax:503-558-6893
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant