| Healthy Living Family Medicine, Llc | |
|
314 Ne 19th Ave Portland OR 97232-2829 | |
| (503) 239-8181 | |
| (503) 548-4013 |
| Full Name | Healthy Living Family Medicine, Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 314 Ne 19th Ave, Portland, Oregon |
| Authorized Official Name and Position | Kerry A Pullium (PRESIDENT) |
| Authorized Official Contact | 5032398181 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Healthy Living Family Medicine, Llc 314 Ne 19th Ave Portland OR 97232-2829 Ph: (503) 239-8181 | Healthy Living Family Medicine, Llc 314 Ne 19th Ave Portland OR 97232-2829 Ph: (503) 239-8181 |
| NPI Number | 1376893826 |
|---|---|
| Provider Enumeration Date | 09/12/2012 |
| Last Update Date | 09/12/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1376893826 | NPI | - | NPPES |
| 1497902373 | Other | NPI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | MD151149 (* (Not Available)) | Primary |
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