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NPI Code Detail

MEDICARE: ELIZABETH TACVORIAN MD

MEDICARE: ELIZABETH TACVORIAN MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1208M00000XHospitalist PhysicianMD25881OR

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1467414417
Entity Type Code : Individual
Provider Name (Legal Business Name) : ELIZABETH TACVORIAN MD
Provider Business Mailing Address
First Line : 5130 SE 30TH AVE
Second Line : APT #12
City : PORTLAND
State : OR
Zip : 97202-4557
Country : US
Telephone Number : 503-913-4819
Fax Number :
Provider Business Practice Location Address
First Line : 19300 SW 65TH AVE
Second Line :
City : TUALATIN
State : OR
Zip : 97062-7706
Country : US
Telephone Number : 505-938-1800
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/05/2006
Last Update Date : 03/25/2011

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Directions to “ ELIZABETH TACVORIAN MD” Practice Location

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