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NPI Code Detail

MEDICARE: MS. MADELINE MARIE CREAGAN

MEDICARE:  MS. MADELINE MARIE CREAGAN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YM0800XMental Health Counselor

General Provider Information

NPI Number : 1235749730
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. MADELINE MARIE CREAGAN
Provider Business Mailing Address
First Line : 5200 MEADOWS RD STE 2000
Second Line :
City : LAKE OSWEGO
State : OR
Zip : 97035-3202
Country : US
Telephone Number : 541-975-3868
Fax Number :
Provider Business Practice Location Address
First Line : 5200 MEADOWS RD STE 2000
Second Line :
City : LAKE OSWEGO
State : OR
Zip : 97035-3202
Country : US
Telephone Number : 541-975-3868
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/09/2020
Last Update Date : 05/29/2024

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Directions to “ MS. MADELINE MARIE CREAGAN ” Practice Location

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