Organization
HEALTHY LIVING FAMILY MEDICINE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KERRY A PULLIUM MD (PRESIDENT)
(503) 239-8181
Entity
Organization
Contact information
Practice address
314 NE 19TH AVE, PORTLAND, OR 97232-2829
(503) 239-8181
(503) 548-4013
Mailing address
314 NE 19TH AVE, PORTLAND, OR 97232-2829
(503) 239-8181
(503) 548-4013
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD151149
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1497902373
NPI
—
Enumeration date
09/12/2012
Last updated
09/12/2012
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