Individual
INNA V VELYCHKO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
9300 SE 91ST AVE STE 201, PORTLAND, OR 97086-3762
(503) 387-7111
(503) 567-7706
Mailing address
PO BOX 226, BRUSH PRAIRIE, WA 98606-0226
(503) 387-7111
(971) 288-1045
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
57.012943
OH
207Q00000X
Family Medicine Physician
MD183825
OR
207Q00000X
Family Medicine Physician
Primary
MD60155804
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0265038
L & I
WA
05
—
1609036771
—
WA
Enumeration date
06/12/2008
Last updated
11/13/2025
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