Provider Demographics
NPI:1790851574
Name:DRASIN, DENA K (MD)
Entity Type:Individual
Prefix:DR
First Name:DENA
Middle Name:K
Last Name:DRASIN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6834 SE 28TH AVE
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97202-8705
Mailing Address - Country:US
Mailing Address - Phone:503-720-1313
Mailing Address - Fax:503-788-9922
Practice Address - Street 1:6834 SE 28TH AVE
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97202-8705
Practice Address - Country:US
Practice Address - Phone:503-720-1313
Practice Address - Fax:503-788-9922
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OROR MD 240552084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
ORC50594Medicare UPIN