Individual provider Active NPI

Inna V Velychko, M.D.

  • Family Medicine Physician
  • Portland, OR
National Provider Identifier
1609036771
Registry record updated Nov 13, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD60155804 Issued in WA
Practice address
9300 SE 91St Ave Ste 201
Portland, OR 97086-3762
Phone
(503) 387-7111
Fax
(503) 567-7706
NPI assigned
Jun 12, 2008
Last updated
Nov 13, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 13, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 57.012943 OH
Family Medicine Physician 207Q00000X MD183825 OR
Family Medicine Physician 207Q00000X MD60155804 WA Primary

Addresses

Primary practice location

9300 SE 91St Ave Ste 201
Portland, OR 97086-3762

Mailing address

PO Box 226
Brush Prairie, WA 98606-0226
Phone (503) 387-7111

Other practice location 1

2525 NE 139th St
Vancouver, WA 98686-2719
Phone (360) 882-2778

Other identifiers 2

IdentifierTypeStateIssuer
1609036771MedicaidWA
0265038OtherWAL & I

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA, OR2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20100816000559 WA Practitioner - Family Practice 2668506445 Reassigns benefits to 1 organization
I20171025002980 OR Practitioner - Family Practice 2668506445 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
57.012943OHMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Sunrise Corporate Services, LLC Family Medicine CurrentSince Oct 9, 2017 Accepting new patients
Aaim Care LLC PastSince Oct 9, 2017 Accepting new patients

Locations

9300 SE 91st Ave
Ste 201
Portland, OR 97086
Phone (503) 387-7111

Interoperability endpoints

  • Direct secure messaging: inna.velychko@152951370743812.direct.elationemr.com

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1213228800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1762992000000",
    "number": "1609036771",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 226",
            "city": "BRUSH PRAIRIE",
            "state": "WA",
            "postal_code": "986060226",
            "telephone_number": "503-387-7111",
            "fax_number": "971-288-1045"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9300 SE 91ST AVE STE 201",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "970863762",
            "telephone_number": "503-387-7111",
            "fax_number": "503-567-7706"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2525 NE 139th St",
            "address_purpose": "LOCATION",
            "city": "Vancouver",
            "state": "WA",
            "postal_code": "986862719",
            "country_code": "US",
            "telephone_number": "360-882-2778",
            "fax_number": "360-604-1675",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VELYCHKO",
        "first_name": "INNA",
        "middle_name": "V",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-06-12",
        "last_updated": "2025-11-13",
        "certification_date": "2025-11-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OH",
            "license": "57.012943",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OR",
            "license": "MD183825",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WA",
            "license": "MD60155804",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1609036771",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "L & I",
            "identifier": "0265038",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

Verify at the official NPI Registry.