Organization
CRAGON INC.
Active
Other names
Crary Shoe Mfg. Co.
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MEREDITH A JOHANSON C PED (VICE PRESIDENT)
(503) 253-8984
Entity
Organization
Contact information
Practice address
9900 SW GREENBURG RD, SUITE 190, PORTLAND, OR 97223-5502
(503) 670-7600
(503) 670-7009
Mailing address
PO BOX 20458, PORTLAND, OR 97294-0458
(503) 253-8984
(503) 253-8984
Taxonomy
Speciality
Code
Description
License number
State
332BC3200X
Customized Equipment (DME)
Primary
—
—
Other
Enumeration date
01/29/2009
Last updated
06/29/2010
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