Leroy Augustus - Portland, OR

Leroy Augustus

Peer Specialist in Portland, Oregon

NPI 1538527320

Leroy Augustus is a Peer Specialist based in Portland, OR. Leroy Augustus practices in Portland, OR. The NPI Number for Leroy Augustus is 1538527320 and holds a License No. 16-CRM-003 (Oregon).

The current practice location address for Leroy Augustus is 10570 Se Washington St, Portland, OR and can be reached out via phone at 971-334-2005.

Location: 10570 Se Washington St, Portland, OR, 97216-2809

NPI Number

1538527320

Provider Name

Leroy Augustus

Credential

Provider Entity Type

Individual

Gender

Male

Address

10570 Se Washington St, Portland, OR, 97216-2809

Phone Number

971-334-2005

Fax Number

Provider Enumeration Date

02/08/2016

Last Update Date

03/09/2024

Identifier	Type	State	Issuer
16-CRM-003	05	OR

Address

10570 Se Washington St

City

Portland

State

Oregon

Zip

97216-2846

Phone Number

971-334-2005

Fax Number

Address

10570 Se Washington St

City

Portland

State

Oregon

Zip

97216-2846

Phone Number

971-334-2005

Fax Number

Type

Other Service Providers

Classification

Peer Specialist

Speciality

Taxonomy

175T00000X

License No.

16-CRM-003 (Oregon)

Definition

Individuals certified to perform peer support services through a training process defined by a government agency, such as the Department of Veterans Affairs or a state mental health department/certification/licensing authority.

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