Provider Demographics
NPI:1093294928
Name:CREEL, SONJA (MPT)
Entity Type:Individual
Prefix:
First Name:SONJA
Middle Name:
Last Name:CREEL
Suffix:
Gender:F
Credentials:MPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9290 SE SUNNYBROOK BLVD STE 230
Mailing Address - Street 2:
Mailing Address - City:CLACKAMAS
Mailing Address - State:OR
Mailing Address - Zip Code:97015-6777
Mailing Address - Country:US
Mailing Address - Phone:503-215-2085
Mailing Address - Fax:503-215-2185
Practice Address - Street 1:9290 SE SUNNYBROOK BLVD STE 230
Practice Address - Street 2:
Practice Address - City:CLACKAMAS
Practice Address - State:OR
Practice Address - Zip Code:97015-6777
Practice Address - Country:US
Practice Address - Phone:503-215-2085
Practice Address - Fax:503-215-2185
Is Sole Proprietor?:No
Enumeration Date:2018-08-10
Last Update Date:2018-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR048732251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic