Organization
HEALTHY LIVING COMMUNITY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MATTHEW S WHITACRE MD (MEDICAL DIRECTOR / MD)
(360) 640-8833
Entity
Organization
Contact information
Practice address
3605 SE 26TH AVE, PORTLAND, OR 97202-2953
(971) 231-4536
(503) 376-3790
Mailing address
3605 SE 26TH AVE, PORTLAND, OR 97202-2953
(971) 231-4536
(503) 376-3790
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
261Q00000X
Clinic/Center
Primary
—
—
Other
Enumeration date
06/18/2019
Last updated
07/26/2023
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