Evylon Aymea Rose Whitacre, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

MD215234 Issued in OR

Practice address

3605 SE 26TH Ave
Portland, OR 97202-2953

Phone

(971) 231-4536

Fax

(503) 376-3790

NPI assigned

May 8, 2008

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 1

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

Specialty

General Practice

Education

Other, 2007

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Healthy Living CommunityGroup PAC ID 6204277817, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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

• Healthy Living Community

  • Clinic/Center
  • Portland, OR
  • NPI 1700446085

  Family Medicine

  Medicare reassignment Care Compare group NPD
• Lower Elwha Klallam Tribe

  • Primary Care Clinic/Center
  • Port Angeles, WA
  • NPI 1821114026
  Medicare reassignment NPD

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

{
    "created_epoch": "1210204800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1766966400000",
    "number": "1730356858",
    "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": {
        "last_name": "WHITACRE",
        "first_name": "EVYLON",
        "middle_name": "AYMEA ROSE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-05-08",
        "last_updated": "2025-12-29",
        "certification_date": "2025-12-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OR",
            "license": "MD215234",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WA",
            "license": "MD60106651",
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "WA",
            "license": "MD60106651",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE",
            "identifier": "MD60106651",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sarah Anne Whipple, BS, R-AAC
• Natalie Whisenant, QMHA
• Erin Rose Whisman, RN
• Brad Harold Whisnant, LAC
• Jeremy Whiston, MA
• Faye A Whitacre, O.T.
• William C. Whitacre, CRNA
• Jeffrey Daniel Whitaker, DNP, PMHNP-BC
• Jesse Kathleen Whitaker
• Nancy Whitakeremrich, L.M.F.T.

• 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 Dec 29, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.