Individual
JOHN MATTHEW CREASY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4805 NE GLISAN ST STE 11N, PORTLAND, OR 97213-2933
(503) 215-8650
Mailing address
PO BOX 3158, PORTLAND, OR 97208-3158
(503) 215-6494
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
MD205855
OR
2086X0206X
Surgical Oncology Physician
Primary
MD205855
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2182679
—
WA
05
—
500795850
—
OR
Enumeration date
03/26/2012
Last updated
04/19/2024
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