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
Phone: (971) 334-2005
Fax:
Website:
Health care specialties
| Specialty | Code | License # | 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1538527320 | NPPES |
| Oregon | MEDICAID | 16-CRM-003 |
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