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:
Health care specialties
| Specialty | Code | License # | 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 2 years 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1336415140 | NPPES |
| Oregon | MEDICAID | 500795850 | |
| Oregon | MEDICAID | 2182679 |
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