Dr. Anatoliy Vlasenko, MD
Emergency Medicine in Portland, OR. Individual provider (NPI-1).
NPI number1083174924
StatusActive
Last updated in NPPESJun 9, 2022
Details
- NPI
- 1083174924
- Entity type
- Individual (NPI-1)
- Name
- Dr. Anatoliy Vlasenko
- Credential
- MD
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Mar 25, 2019
- Certification date
- Jun 9, 2022
- Last updated
- Jun 9, 2022
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207P00000X | Emergency Medicine | MD211230 | OR | Yes |
| 390200000X | Student in an Organized Health Care Education/Training Program | – | – |
Practice location
3181 Sw Sam Jackson Park RdPortland, OR 97239-3011
Phone 503-494-7551 · Fax 503-494-4997
Mailing address
3181 Sw Sam Jackson Park RdPortland, OR 97239-3011
Phone 503-494-7551 · Fax 503-494-4997
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