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

Nickolas Petragallo, CRM/PSS

Individual provider Peer Specialist · NPI 1740887561

Nickolas Petragallo, CRM/PSS is a Peer Specialist in Bend, Oregon. Licensed in Oregon. Registered with an NPI since 2020.

Licensed in
OR
In the registry since
2020
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Practice location Address checks out

908 NE 4th St Ste 101
Bend, OR 97701-4646
Phone: (541) 617-7365
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Peer Specialist (primary) Taxonomy 175T00000X · Licence 20-CRM-242 (OR)

Record details

NPI number1740887561
Entity typeIndividual (Type 1)
GenderMale
Credentials CRM/PSS
Sole proprietorNo
NPI enumeratedOctober 5, 2020
Last updated in NPPESOctober 5, 2020
Certification dateOctober 5, 2020

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