Augustus, Leroy

Augustus, Leroy is an individual health care provider with primary practice located at 10570 Se Washington St , Portland OR 97216-2846. He recently has only one registered license in Other Service Providers / Peer Specialist, which is considered as his primary health care specialty. Augustus, Leroy can be contacted via phone (971) 334-2005.

Contact Information

Primary practice address
10570 Se Washington St Portland OR 97216-2846
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Peer Specialist 175T00000X 16-CRM-003 Oregon

Profile Details

NPI number 1538527320
LBN Legal business name Augustus, Leroy
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 8th, 2016
Last updated Feb 8th, 2016 - about 10 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

Request for update

Identifiers

StateTypeNumberIssuer
All States NPI 1538527320 NPPES
Oregon MEDICAID 16-CRM-003

Popular Providers