Healthy Living Family Medicine, LLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

MD151149

Legal business name

HEALTHY LIVING FAMILY MEDICINE, LLC

Practice address

314 NE 19TH Ave
Portland, OR 97232-2829

Phone

(503) 239-8181

Fax

(503) 548-4013

NPI assigned

Sep 12, 2012

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Kerry A Pullium, MD

Title

President

Phone

(503) 239-8181

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1347408000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1347408000000",
    "number": "1376893826",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "314 NE 19TH AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972322829",
            "telephone_number": "503-239-8181",
            "fax_number": "503-548-4013"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "314 NE 19TH AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972322829",
            "telephone_number": "503-239-8181",
            "fax_number": "503-548-4013"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEALTHY LIVING FAMILY MEDICINE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-09-12",
        "last_updated": "2012-09-12",
        "status": "A",
        "authorized_official_last_name": "PULLIUM",
        "authorized_official_first_name": "KERRY",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "503-239-8181",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": "MD151149",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1497902373",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Healthy at Home LLC
• Healthy Family Wellness
• Healthy Happy Now Natural Medicine
• Healthy Living at Home - Portland LLC
• Healthy Living Community
• Healthy Living Internal Medicine LLC
• Healthy Options Inc
• Healthy Options Inc.
• Healthy Smiles Dental Hygiene Clinic
• Angelie Rose Healy Cleaver, LCSW

• Family Medicine Physician in Portland, OR
• Providers in Portland, OR by specialty
• Family Medicine Physician in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.