Provider Demographics
NPI:1508087545
Name:SCHOEN, CREAGH HAWES (NURSE PRACTITIONER)
Entity type:Individual
Prefix:MS
First Name:CREAGH
Middle Name:HAWES
Last Name:SCHOEN
Suffix:
Gender:F
Credentials:NURSE PRACTITIONER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:1130 NW 22ND AVENUE, STE 640
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97210
Mailing Address - Country:US
Mailing Address - Phone:503-229-7976
Mailing Address - Fax:503-274-4867
Practice Address - Street 1:232 NE NORTON LN
Practice Address - Street 2:
Practice Address - City:MCMINNVILLE
Practice Address - State:OR
Practice Address - Zip Code:97128-8470
Practice Address - Country:US
Practice Address - Phone:503-434-1159
Practice Address - Fax:503-434-1190
Is Sole Proprietor?:No
Enumeration Date:2007-05-01
Last Update Date:2024-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR200350100NP363L00000X
OR082010198RN163W00000X
OR082010198N7363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163W00000XNursing Service ProvidersRegistered Nurse
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR500642651Medicaid
WA2082038Medicaid