Individual
KRISTELL MARIE WADE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
604 MEDICAL PARKWAY, ENTERPRISE, OR 97828
(541) 426-5306
Mailing address
79360 WADE GULCH LANE, LOSTINE, OR 97857
(541) 263-1465
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
—
OR
367500000X
Certified Registered Nurse Anesthetist
Primary
—
OR
Other
Enumeration date
08/09/2006
Last updated
09/11/2025
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