Individual provider · Type 1 NPI

Ivan Dassenko, MD

General Practice Physician · Salem, OR

NPI number 1104028364 Active

Practice location

6810 Canyon St SE
Salem, OR 97317-9024

Call (503) 581-7379 Map

Fax (503) 585-7816

Specialties and licenses

TaxonomyCodeLicense
General Practice Physician Primary 208D00000X6160 (OR)

General Practice Physician: A physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions.

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About NPI 1104028364

Ivan Dassenko, MD's National Provider Identifier is 1104028364, issued on Jun 1, 2007. The primary taxonomy on file is General Practice Physician (208D00000X), and the practice location is in Salem, OR. The record was last updated on Jul 8, 2007.