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CRYSTAL ROSE
NPI 1235849555
Licensed Practical Nurse in Portland, OR

Active since November 28, 2022
9750 NE GLISAN ST, PORTLAND, OR 97220(928) 671-0904 Get Directions Write a Review

NPPES record last updated: April 17, 2024. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Apr 17, 2024, Nov 28, 2022 (2 updates tracked since 2022).

About Crystal Rose NPPES

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

CRYSTAL ROSE (NPI 1235849555) is an individual licensed practical nurse in Portland, Oregon, licensed in Oregon (202209494) and active in the NPI registry since November 2022.

NPPES Registry Identity

NPI1235849555
Entity TypeIndividualFemale
Primary Taxonomy164W00000X
Provider Legal NameCRYSTAL ROSE
Location Address9750 NE GLISAN STPortland, OR 97220-4449
Mailing Address17180 W Sweetwater Ave Unit 1088Surprise, AZ 85388-3404 · (928) 671-0904
Phone(928) 671-0904
Sole ProprietorYes
Enumeration DateNovember 28, 2022
Last NPPES UpdateApril 17, 20242 updates tracked since enumeration
NPPES CertifiedApril 16, 2024
✔ NPI 1235849555 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyLicensed Practical NurseNursing Service Providers
Taxonomy Code164W00000X
License✔ Licensed in OR · 202209494
Definition
A licensed practical nurse with post-high school vocational training and practical experience in the provision of nursing care at a level less than that required for certification as a Registered Nurse. Requirements for education, experience, licensure, and job responsibilities vary among the states.
Also ListedRegistered NurseTaxonomy 163W00000X · License 202209494 (OR)
9750 NE GLISAN ST, Portland, OR 97220
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Other Providers at the Same Location NPPES 12

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

JOHN BLOMBERG PTA
Community Health Worker
9750 NE GLISAN ST
PORTLAND, OR 97220
Multnomah County (503) 256-3920
SUSAN B WIGGINS M.ED, M.S
Speech-Language Pathologist
9750 NE GLISAN ST
PORTLAND, OR 97220
Multnomah County (503) 256-3920
ARETHA L JOHNSON LPN
Licensed Practical Nurse
9750 NE GLISAN ST
PORTLAND, OR 97220
Multnomah County (503) 256-3920
MS. PAULETTE A WHEELER MOT, OTR/L
Occupational Therapist
9750 NE GLISAN ST
PORTLAND, OR 97220
Multnomah County (503) 256-3920
EMILY BURTON
Occupational Therapist
9750 NE GLISAN ST
PORTLAND, OR 97220
Multnomah County (503) 256-3920
MRS. LOIS ELLEN PYLES COTA/L
Occupational Therapy Assistant
9750 NE GLISAN ST
PORTLAND, OR 97220
Multnomah County (503) 256-3920
MRS. NICOLE IRENE HAMMONDS PTA
Physical Therapy Assistant
9750 NE GLISAN ST
PORTLAND, OR 97220
Multnomah County (503) 256-3920
MRS. JESSICA DAWN ENDERTON MSPT
Physical Therapist
9750 NE GLISAN ST
PORTLAND, OR 97220
Multnomah County (503) 256-3920

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Crystal Rose's NPI number?

The NPI number for Crystal Rose is 1235849555. It was assigned to this individual provider in the NPPES registry on November 28, 2022.

Where is Crystal Rose located?

Crystal Rose practices at 9750 NE Glisan St, Portland, OR 97220. The listed phone number is (928) 671-0904.

What is Crystal Rose's specialty?

The primary specialty registered for this NPI is Licensed Practical Nurse with taxonomy code 164W00000X.

When was this NPI record last updated?

The NPPES record for Crystal Rose was last updated on April 17, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.