Basic Information
| Provider Information | |||||||||
| NPI: | 1821187089 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | CRONE | ||||||||
| FirstName: | PAULA | ||||||||
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| Credential: | D.O. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 9200 SE 91ST AVE | ||||||||
| Address2: | STE 220 | ||||||||
| City: | HAPPY VALLEY | ||||||||
| State: | OR | ||||||||
| PostalCode: | 970863756 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5032397030 | ||||||||
| FaxNumber: | 5032397220 | ||||||||
| Practice Location | |||||||||
| Address1: | 9200 SE 91ST AVE | ||||||||
| Address2: | STE 220 | ||||||||
| City: | HAPPY VALLEY | ||||||||
| State: | OR | ||||||||
| PostalCode: | 970863756 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5032397030 | ||||||||
| FaxNumber: | 5032397220 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/12/2006 | ||||||||
| LastUpdateDate: | 07/14/2010 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | DO18239 | OR | Y | Allopathic & Osteopathic Physicians | Family Medicine |
ID Information
| ID | Type | State | Issuer | Description | 057849 | 05 | OR | MEDICAID | 058443000 | 01 | OR | BLUE CROSS | OTHER |