# VICTOR N TAKLA MD LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1649413139
- **Authorized official:** DR. VICTOR N TAKLA MD (PRESIDENT)
- **Authorized official phone:** (208) 667-6511

## Contact information

- **Practice address:** 1015 NW 22ND AVE, PORTLAND, OR 97210-3025
- **Practice address phone:** (208) 667-6511
- **Practice address fax:** (208) 666-1642
- **Mailing address:** 4136 NW THUNDER CREST RD, PORTLAND, OR 97229-8028
- **Mailing address phone:** (208) 667-6511
- **Mailing address fax:** (208) 666-1642

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207L00000X | Anesthesiology Physician | MD15896 | OR | Yes |

## Other

- **Enumeration date:** 04/13/2009
- **Last updated:** 04/13/2009