# CREEKSIDE FAMILY PRACTICE, LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1508055781
- **Authorized official:** PAULA MARIE CRONE D.O. (PRESIDENT)
- **Authorized official phone:** (503) 239-7030

## Contact information

- **Practice address:** 9200 SE 91ST AVE, SUITE \#220, HAPPY VALLEY, OR 97086-3756
- **Practice address phone:** (503) 239-7030
- **Practice address fax:** (503) 239-7220
- **Mailing address:** 9200 SE 91ST AVE, SUITE \#220, HAPPY VALLEY, OR 97086-3756
- **Mailing address phone:** (503) 239-7030
- **Mailing address fax:** (503) 239-7220

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 10/23/2007
- **Last updated:** 10/23/2007