Cragon Inc

Primary specialty

Customized Equipment (DME)Taxonomy code 332BC3200X

Legal business name

CRAGON INC

Doing business as

CRARY SHOES
Crary Shoe Mfg Co

Practice address

12035 NE Glenn Widing Dr
Portland, OR 97220-9050

Phone

(503) 253-8984

Fax

(503) 253-2094

NPI assigned

Sep 25, 2006

Organization subpart

No

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

Authorized official

Name

Meredith Johanson

Title

Vice President

Phone

(503) 253-8984

Specialties & licenses 1

Addresses

Other identifiers 5

Other names 2

• CRARY SHOES Doing business as
• Crary Shoe Mfg Co Doing business as

Medicare fee-for-service enrollment

Enrolled in OR

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

Locations

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

{
    "created_epoch": "1159142400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1720742400000",
    "number": "1437250461",
    "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": "503-253-2094"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12035 NE GLENN WIDING DR",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972209050",
            "telephone_number": "503-253-8984",
            "fax_number": "503-253-2094"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CRAGON INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-25",
        "last_updated": "2024-07-12",
        "certification_date": "2024-07-12",
        "status": "A",
        "authorized_official_last_name": "JOHANSON",
        "authorized_official_first_name": "MEREDITH",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "503-253-8984"
    },
    "taxonomies": [
        {
            "code": "332BC3200X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Customized Equipment",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WASHINGTON MEDICAID",
            "identifier": "9039694",
            "state": "OR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "063169",
            "state": "OR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "875018000",
            "state": "OR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DEPARTMENT OF LABOR AND INDUSTRIES",
            "identifier": "0058824",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9039694",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CRARY SHOES",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Crary Shoe Mfg Co",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Lesley E Crafts, LPC
• Tamara Lea Crafts
• Trevor Crafts, M.D.
• Alyxandria Taylor Crager
• Ana Cragnolino, PH.D.
• Cragon Inc.
• Craig F. Zarling, MD, LLC
• Craig Gonzales, DC LLC
• Craig Hertler MD LLC
• Craig P. Greenberg, M.D.

• Customized Equipment (DME) in Portland, OR
• Providers in Portland, OR by specialty
• Customized Equipment (DME) in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.