Organization Active NPI

Cragon Inc.

  • Customized Equipment (DME)
  • Portland, OR
National Provider Identifier
1336387372
Registry record updated Jun 29, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Customized Equipment (DME)Taxonomy code 332BC3200X
Legal business name
CRAGON INC.
Doing business as
Crary Shoe Mfg. Co.
Practice address
9900 SW Greenburg Rd
Suite 190
Portland, OR 97223-5502
Phone
(503) 670-7600
Fax
(503) 670-7009
NPI assigned
Jan 29, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 29, 2010

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mrs. Meredith A Johanson, C PED
Title
Vice President
Phone
(503) 253-8984

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Customized Equipment (DME) 332BC3200X Primary

Addresses

Primary practice location

9900 SW Greenburg Rd
Suite 190
Portland, OR 97223-5502

Mailing address

PO Box 20458
Portland, OR 97294-0458
Phone (503) 253-8984

Other names 1

  • Crary Shoe Mfg. Co. Doing business as

National Provider Directory

National Provider Directory

Locations

9900 SW Greenburg Rd
Ste 190
Portland, OR 97223
Phone (503) 670-7600

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1233187200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1277769600000",
    "number": "1336387372",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 20458",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972940458",
            "telephone_number": "503-253-8984",
            "fax_number": "503-253-8984"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9900 SW GREENBURG RD",
            "address_2": "SUITE 190",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972235502",
            "telephone_number": "503-670-7600",
            "fax_number": "503-670-7009"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CRAGON INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-01-29",
        "last_updated": "2010-06-29",
        "status": "A",
        "authorized_official_last_name": "JOHANSON",
        "authorized_official_first_name": "MEREDITH",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "503-253-8984",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "C PED"
    },
    "taxonomies": [
        {
            "code": "332BC3200X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Customized Equipment",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Crary Shoe Mfg. Co.",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Portland, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.