Individual
CRYSTAL ANN STRADER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PSS
Contact information
Practice address
1333 NW 9TH ST, PRINEVILLE, OR 97754-1482
(541) 447-2631
Mailing address
1333 NW 9TH ST, PRINEVILLE, OR 97754-1482
(541) 447-2631
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
112259
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
112259
THW
OR
Enumeration date
11/10/2025
Last updated
11/10/2025
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