Provider Demographics
NPI:1235725946
Name:DATO, LEONARD ALLAN
Entity Type:Individual
Prefix:
First Name:LEONARD
Middle Name:ALLAN
Last Name:DATO
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:161 HIGH ST SE STE 209
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:OR
Mailing Address - Zip Code:97301-3693
Mailing Address - Country:US
Mailing Address - Phone:503-560-0802
Mailing Address - Fax:
Practice Address - Street 1:161 HIGH ST SE STE 209
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:OR
Practice Address - Zip Code:97301-3693
Practice Address - Country:US
Practice Address - Phone:503-560-0802
Practice Address - Fax:971-273-7253
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-16
Last Update Date:2020-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR174956095347C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes347C00000XTransportation ServicesPrivate Vehicle