Healthy Living Community

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

Legal business name

HEALTHY LIVING COMMUNITY

Practice address

3605 SE 26TH Ave
Portland, OR 97202-2953

Phone

(971) 231-4536

Fax

(503) 376-3790

NPI assigned

Jun 18, 2019

Organization subpart

No

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

Authorized official

Name

Matthew S Whitacre, MD

Title

Medical Director / MD

Phone

(360) 640-8833

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in OR

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Suzanne Windy Lyle, FNP

  • Family Nurse Practitioner
  • Portland, OR
  • NPI 1962419721
  Medicare reassignment Care Compare group NPD
• Evylon Aymea Rose Whitacre, M.D.

  • Family Medicine Physician
  • Portland, OR
  • NPI 1730356858
  Medicare reassignment Care Compare group NPD
• Maleah Ermac, N.D.

  • Naturopath
  • Portland, OR
  • NPI 1215246426
  NPD (past)
• Megan S Golani, N.D.

  • Naturopath
  • Portland, OR
  • NPI 1205188265
  NPD (past)

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

{
    "created_epoch": "1560816000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1690329600000",
    "number": "1700446085",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3605 SE 26TH AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972022953",
            "telephone_number": "971-231-4536",
            "fax_number": "503-376-3790"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3605 SE 26TH AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972022953",
            "telephone_number": "971-231-4536",
            "fax_number": "503-376-3790"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEALTHY LIVING COMMUNITY",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-06-18",
        "last_updated": "2023-07-26",
        "certification_date": "2023-07-26",
        "status": "A",
        "authorized_official_last_name": "WHITACRE",
        "authorized_official_first_name": "MATTHEW",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR / MD",
        "authorized_official_telephone_number": "360-640-8833",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Healthstat on-Site Clinic/Saif 2ND Location
• Healthy at Home LLC (Healthy at Home Providers)
• Healthy Family Wellness
• Healthy Happy Now Natural Medicine
• Healthy Living at Home - Portland LLC (Mission Home Health of Portland)
• Healthy Living Family Medicine, LLC
• Healthy Living Internal Medicine LLC
• Healthy Options Inc (Postal Prescription Services)
• Healthy Options Inc. (Postal Prescription Services)
• Healthy Smiles Dental Hygiene Clinic

• Clinic/Center in Portland, OR
• Providers in Portland, OR by specialty
• Clinic/Center in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.