BETHANIE WILSON CRM
NPI 1104708015
Peer Specialist in Gresham, OR

Q: What is the provider's specialty?

The provider's specialty is Peer Specialist with taxonomy code 175T00000X.

Active since July 22, 2025

1217 NE BURNSIDE RD STE 701, GRESHAM, OR 97030(503) 740-1971 Get Directions Write a Review

NPPES record last updated: July 22, 2025. Verified against the NPPES registry weekly; last sync: July 19, 2026.

On this page

About Bethanie Wilson Crm NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

BETHANIE WILSON CRM (NPI 1104708015) is an individual peer specialist in Gresham, Oregon, licensed in Oregon (25-CRM-4634) and active in the NPI registry since July 2025.

NPPES Registry Identity

NPI1104708015

Entity TypeIndividualFemale

Primary Taxonomy175T00000X

Provider Legal NameBETHANIE WILSONCredential: CRM

Location Address1217 NE BURNSIDE RD STE 701Gresham, OR 97030-5770

Mailing Address1217 Ne Burnside Rd Ste 701Gresham, OR 97030-5770 · (503) 740-1971

Phone(503) 740-1971

Sole ProprietorNo

Enumeration DateJuly 22, 2025

NPPES CertifiedJuly 22, 2025

✔ NPI 1104708015 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPeer SpecialistOther Service Providers

Taxonomy Code175T00000X

License✔ Licensed in OR · 25-CRM-4634

Definition

Individuals certified to perform peer support services through a training process defined by a government agency, such as the Department of Veterans Affairs or a state mental health department/certification/licensing authority.

1217 NE BURNSIDE RD STE 701, Gresham, OR 97030

Open in Google Maps ↗