Provider Demographics
NPI:1083137459
Name:SAGUE, DAVID
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:
Last Name:SAGUE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7820 NE HOLMAN ST STE B5
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97218-2841
Mailing Address - Country:US
Mailing Address - Phone:971-276-1290
Mailing Address - Fax:
Practice Address - Street 1:7820 NE HOLMAN ST STE B5
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97218-2841
Practice Address - Country:US
Practice Address - Phone:971-276-1290
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-07-18
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator