Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Crystal Rose

Individual provider Registered Nurse · NPI 1235849555

Crystal Rose is a Registered Nurse in Portland, Oregon. Practices as a sole proprietor. Licensed in Oregon.

Licensed in
OR
In the registry since
2022
Specialties on file
2

Practice location Address checks out

9750 NE Glisan St
Portland, OR 97220-4449
Phone: (928) 671-0904
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Licensed Practical Nurse (primary) Taxonomy 164W00000X · Licence 202209494 (OR)
Registered Nurse Taxonomy 163W00000X · Licence 202209494 (OR)

Record details

NPI number1235849555
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorYes
NPI enumeratedNovember 28, 2022
Last updated in NPPESApril 17, 2024
Certification dateApril 16, 2024
Mailing address17180 W Sweetwater Ave Unit 1088, Surprise, AZ 85388-3404

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