Provider Demographics
NPI:1376885418
Name:DRUSKIN, SASHA COURAND (MD)
Entity Type:Individual
Prefix:
First Name:SASHA
Middle Name:COURAND
Last Name:DRUSKIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2226 NW PETTYGROVE ST
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97210-2608
Mailing Address - Country:US
Mailing Address - Phone:503-223-6223
Mailing Address - Fax:
Practice Address - Street 1:2226 NW PETTYGROVE ST
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97210-2608
Practice Address - Country:US
Practice Address - Phone:503-223-6223
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-03-26
Last Update Date:2019-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORMD191610208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology