Provider Demographics
NPI:1285824383
Name:AUNGST, DENNIS JAMES (DC)
Entity Type:Individual
Prefix:
First Name:DENNIS
Middle Name:JAMES
Last Name:AUNGST
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:D.
Other - Middle Name:JAMES
Other - Last Name:AUNGST
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DC
Mailing Address - Street 1:3807 SW GARDEN HOME RD
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97219-3581
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3807 SW GARDEN HOME RD
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97219-3581
Practice Address - Country:US
Practice Address - Phone:503-546-5665
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-26
Last Update Date:2007-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR27 1444111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
ORT67402Medicare UPIN
OR107849Medicare PIN