Healthcare Provider Details

I. General information

NPI: 1548571136
Provider Name (Legal Business Name): SCOTT KENNETH RASMUSSEN D.P.M.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/29/2010
Last Update Date: 09/28/2026
Certification Date: 09/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1750 13TH ST SE
SALEM OR
97302-2542
US

IV. Provider business mailing address

1750 13TH ST SE
SALEM OR
97302-2542
US

V. Phone/Fax

Practice location:
  • Phone: 503-588-8188
  • Fax: 503-588-8188
Mailing address:
  • Phone: 503-588-8188
  • Fax: 503-588-0884

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213E00000X
TaxonomyPodiatrist
License NumberDP151747
License Number StateOR
# 2
Primary TaxonomyN
Taxonomy Code213ES0131X
TaxonomyFoot Surgery Podiatrist
License NumberDP151747
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: