Individual
CRYSTAL TANNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
340 NW 5TH ST, REDMOND, OR 97756-1869
(541) 516-4087
Mailing address
PO BOX 1710, REDMOND, OR 97756-0516
(541) 516-4087
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
T-22-1608
OR
164W00000X
Licensed Practical Nurse
Primary
201130008LPN
OR
225400000X
Rehabilitation Practitioner
—
—
Other
Enumeration date
05/06/2022
Last updated
04/25/2025
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