Provider Demographics
NPI:1235526849
Name:AUGEE, HOLLIS LULE (MD)
Entity Type:Individual
Prefix:MR
First Name:HOLLIS
Middle Name:LULE
Last Name:AUGEE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5151 S.W. 88TH AVE.
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97225-1717
Mailing Address - Country:US
Mailing Address - Phone:503-292-9592
Mailing Address - Fax:
Practice Address - Street 1:5151 S.W. 88TH AVE.
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97225-1717
Practice Address - Country:US
Practice Address - Phone:503-292-9592
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-04-21
Last Update Date:2015-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORMD06605208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice