Creekside Rehabilitation and Nursing

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

Legal business name

CREEKSIDE REHABILITATION AND NURSING

Practice address

812 SE 48TH Ave
Portland, OR 97215-1724

Phone

(503) 236-2624

NPI assigned

May 26, 2016

Organization subpart

No

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

Authorized official

Name

Walter Eric Myers

Title

Managing Partner

Phone

(801) 709-4358

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1464220800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1480464000000",
    "number": "1407204746",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "812 SE 48TH AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972151724",
            "telephone_number": "503-236-2624"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "812 SE 48TH AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972151724",
            "telephone_number": "503-236-2624"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CREEKSIDE REHABILITATION AND NURSING",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-05-26",
        "last_updated": "2016-11-30",
        "status": "A",
        "authorized_official_last_name": "MYERS",
        "authorized_official_first_name": "WALTER",
        "authorized_official_middle_name": "ERIC",
        "authorized_official_title_or_position": "MANAGING PARTNER",
        "authorized_official_telephone_number": "801-709-4358"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Jeremy Cree, DO
• Bradley James Creel, LPC
• Bonnie J Creitz, MD
• Laura Elizabeth Creitz
• Virginia Creitz
• Mia Beatrice Cremer

• Skilled Nursing Facility in Portland, OR
• Providers in Portland, OR by specialty
• Skilled Nursing Facility in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2016; 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.