Provider Demographics
NPI:1922811793
Name:SAPAUGH, LACEY JO
Entity type:Individual
Prefix:
First Name:LACEY
Middle Name:JO
Last Name:SAPAUGH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:777 COLLEGE PARK DR SW UNIT 98
Mailing Address - Street 2:
Mailing Address - City:ALBANY
Mailing Address - State:OR
Mailing Address - Zip Code:97322-8437
Mailing Address - Country:US
Mailing Address - Phone:541-730-1044
Mailing Address - Fax:
Practice Address - Street 1:777 COLLEGE PARK DR SW UNIT 98
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:OR
Practice Address - Zip Code:97322-8437
Practice Address - Country:US
Practice Address - Phone:541-730-1044
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-01-27
Last Update Date:2025-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care