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General NPI Number Information
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NPI Number | 1114407301
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Entity Type | Individual
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Provider Name | CRYSTAL LUNA MSN, APRN-RX, FNP-BC
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Gender | Female
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Dates
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Enumeration Date | 08/16/2018
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Last Update Date | 04/04/2025
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Provider Practice Location Address
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Address Line | 2245 NE ALLIE AVE STE 19
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City | HILLSBORO
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State | OR
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Zip | 97124-9078
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Country | US
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Telephone | 808-469-7619
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Fax |
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Provider Business Mailing Address
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Address Line | 17358 SW CURTIS LN
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City | BEAVERTON
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State | OR
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Zip | 97007-2200
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Country | US
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Telephone | 808-469-7619
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 201802814NP-PP
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License Number State | OR
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