Provider Demographics
NPI:1316655509
Name:EMPIE, AUGUSTUS R
Entity type:Individual
Prefix:
First Name:AUGUSTUS
Middle Name:R
Last Name:EMPIE
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 1:2406 NW 61ST ST APT 301
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98107-5352
Mailing Address - Country:US
Mailing Address - Phone:406-471-0834
Mailing Address - Fax:
Practice Address - Street 1:1111 N NORTHGATE WAY APT 301
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98133-8913
Practice Address - Country:US
Practice Address - Phone:206-523-2225
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-11-07
Last Update Date:2022-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA61186228225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist