Individual
ANITA AUGUST
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
300 NW 8TH AVE APT 707, PORTLAND, OR 97209-3560
(503) 464-9395
(503) 464-9396
Mailing address
300 NW 8TH AVE APT 707, PORTLAND, OR 97209-3560
(503) 464-9395
(503) 464-9396
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
3376
OR
320700000X
Physical Disabilities Residential Treatment Facility
PT 3376
OR
Other
Enumeration date
06/14/2009
Last updated
06/14/2009
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