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1104028364
IVAN DASSENKO
SALEM, OR
NPI
1104028364
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
208D00000X General Practice
(Licence: OR 6160)
Enumeration Date
2007-06-01
Last Update Date
2007-07-08
Business Address
Dr. IVAN DASSENKO MD
6810 CANYON ST SE
SALEM, OR 97317-9024
Phone number: 503-581-7379
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Mailing Address
Dr. IVAN DASSENKO MD
6810 CANYON ST SE
SALEM, OR 97317-9024
Phone number: 503-581-7379
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