Creasy, John Matthew

Creasy, John Matthew is an individual health care provider with primary practice located at 4805 Ne Glisan St Ste 11N , Portland OR 97213-2933. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Surgery, Allopathic & Osteopathic Physicians / Surgical Oncology. Allopathic & Osteopathic Physicians / Surgical Oncology is his primary health care specialty. Creasy, John Matthew can be contacted via phone (503) 215-8650.

Contact Information

Primary practice address
4805 Ne Glisan St Ste 11N Portland OR 97213-2933
Phone: (503) 215-8650
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Surgery 208600000X MD205855 Oregon
Allopathic & Osteopathic Physicians / Surgical Oncology 2086X0206X MD205855 Oregon

Profile Details

NPI number 1336415140
LBN Legal business name Creasy, John Matthew
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 26th, 2012
Last updated Apr 19th, 2024 - about 7 months ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1336415140 NPPES
Oregon MEDICAID 500795850
Oregon MEDICAID 2182679

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