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General NPI Number Information
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NPI Number | 1467397729
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Entity Type | Individual
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Provider Name | CHRISTINA DIANA KRUSE
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Gender | Female
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Dates
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Enumeration Date | 04/22/2026
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Last Update Date | 04/22/2026
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Provider Practice Location Address
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Address Line | 139 N 21ST ST
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City | SAINT HELENS
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State | OR
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Zip | 97051-6217
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Country | US
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Telephone | 503-369-2460
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Fax | 503-670-7507
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Provider Business Mailing Address
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Address Line | 3 MONROE PKWY STE P454
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City | LAKE OSWEGO
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State | OR
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Zip | 97035-1486
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Country | US
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Telephone | 303-859-0857
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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 | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number | IHC-ED88B352
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License Number State | OR
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