Provider Demographics
NPI:1235749730
Name:CREAGAN, MADELINE MARIE
Entity type:Individual
Prefix:MS
First Name:MADELINE
Middle Name:MARIE
Last Name:CREAGAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5200 MEADOWS RD STE 2000
Mailing Address - Street 2:
Mailing Address - City:LAKE OSWEGO
Mailing Address - State:OR
Mailing Address - Zip Code:97035-3202
Mailing Address - Country:US
Mailing Address - Phone:541-975-3868
Mailing Address - Fax:
Practice Address - Street 1:5200 MEADOWS RD STE 2000
Practice Address - Street 2:
Practice Address - City:LAKE OSWEGO
Practice Address - State:OR
Practice Address - Zip Code:97035-3202
Practice Address - Country:US
Practice Address - Phone:541-975-3868
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-08-09
Last Update Date:2024-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health