Individual provider · Type 1 NPI

Crystal Ward

Primary Care Nurse Practitioner · Portland, OR

NPI number 1124401799 Active

Practice location

5100 SW Macadam Ave, 200
Portland, OR 97239-6102

Fax (971) 202-5555

Specialties and licenses

TaxonomyCodeLicense
Primary Care Nurse Practitioner Primary 363LP2300X201603126NP (OR)
Primary Care Nurse Practitioner 363LP2300X209012825 (IL)

Primary Care Nurse Practitioner: Definition to come...

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About NPI 1124401799

Crystal Ward's National Provider Identifier is 1124401799, issued on Jul 1, 2015. The primary taxonomy on file is Primary Care Nurse Practitioner (363LP2300X), and the practice location is in Portland, OR. The record was last updated on Oct 4, 2016.