Provider Demographics
NPI:1952138109
Name:AUGUST, KARLEIGH RAE (DAOM, MAOM)
Entity type:Individual
Prefix:
First Name:KARLEIGH
Middle Name:RAE
Last Name:AUGUST
Suffix:
Gender:F
Credentials:DAOM, MAOM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4540 SW DOGWOOD LN APT 13
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97225-2001
Mailing Address - Country:US
Mailing Address - Phone:913-426-3457
Mailing Address - Fax:
Practice Address - Street 1:6511 N INTERSTATE AVE
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97217-4835
Practice Address - Country:US
Practice Address - Phone:503-433-5702
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-09-19
Last Update Date:2024-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORAC219647171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist