Individual
JOAN MARIE TAKACS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
5909 SE DIVISION ST, PORTLAND, OR 97206-1470
(503) 234-1531
(503) 234-2367
Mailing address
5909 SE DIVISION ST, PORTLAND, OR 97206-1470
(503) 234-1531
(503) 234-2367
Taxonomy
Speciality
Code
Description
License number
State
204D00000X
Neuromusculoskeletal Medicine & OMM Physician
Primary
DO14673
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
048825001
BCBSO
OR
05
—
17705-5
—
OR
Enumeration date
09/02/2005
Last updated
06/24/2010
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