Ivan Dassenko, MD

General Practice Physician · Salem, OR

Individual Active NPI

NPI number 1104028364

Practice location

6810 Canyon St SE
Salem, OR 97317-9024
Phone
(503) 581-7379
Fax
(503) 585-7816

Open in Google Maps

NPI record

NPI
1104028364
Entity type
Individual (Type 1)
Enumeration date
June 1, 2007
Last updated
July 8, 2007
Sole proprietor
No

Specialties & taxonomy codes

TaxonomyCodeLicenseState
General Practice Physician Primary 208D00000X 6160 OR

About Dr. Dassenko

Ivan Dassenko, MD is a healthcare provider registered in the NPI registry with the primary taxonomy General Practice Physician (code 208D00000X). The practice location is 6810 Canyon St SE, Salem, OR 97317-9024. The NPI number 1104028364 was assigned on June 1, 2007 and the record was last updated on July 8, 2007.

Dr. Dassenko lists a license in the registry: #6160 (OR) for General Practice Physician. License numbers are self-reported to NPPES; verify them with the state licensing board.

Frequently asked questions

What is the NPI number of Ivan Dassenko, MD?

The NPI number is 1104028364.

What is the phone number of Dr. Dassenko?

The phone number listed for the practice location is (503) 581-7379.

Where is Dr. Dassenko located?

6810 Canyon St SE, Salem, OR 97317-9024.

What is the taxonomy code for Dr. Dassenko?

The primary taxonomy code is 208D00000X – General Practice Physician.

Is this information correct?

All details come from the public NPPES registry. Providers can update their record at nppes.cms.hhs.gov; changes appear here after the next weekly update.

Other General Practice Physician providers in Salem

All General Practice Physician providers in Salem, OR →