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General NPI Number Information
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NPI Number | 1982568374
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Entity Type | Individual
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Provider Name | CRYSTAL GRABER
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Gender | Female
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Dates
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Enumeration Date | 12/11/2025
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Last Update Date | 12/11/2025
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Provider Practice Location Address
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Address Line | 8950 SE 36TH AVE
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City | MILWAUKIE
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State | OR
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Zip | 97222-5678
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Country | US
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Telephone | 503-353-5320
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Fax |
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Provider Business Mailing Address
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Address Line | 12400 SE FREEMAN WAY
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City | MILWAUKIE
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State | OR
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Zip | 97222-4611
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Country | US
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Telephone | 503-353-6000
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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 | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 200641422RN
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License Number State | OR
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