# HEALTHY LIVING FAMILY MEDICINE, LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1376893826
- **Authorized official:** KERRY A PULLIUM MD (PRESIDENT)
- **Authorized official phone:** (503) 239-8181

## Contact information

- **Practice address:** 314 NE 19TH AVE, PORTLAND, OR 97232-2829
- **Practice address phone:** (503) 239-8181
- **Practice address fax:** (503) 548-4013
- **Mailing address:** 314 NE 19TH AVE, PORTLAND, OR 97232-2829
- **Mailing address phone:** (503) 239-8181
- **Mailing address fax:** (503) 548-4013

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | MD151149 | NULL | Yes |
| 207Q00000X | Family Medicine Physician | MD151149 | — | Yes |

## Other

- **Enumeration date:** 09/12/2012
- **Last updated:** 09/12/2012