Active NPI
Crystal Ann Strader, PSS
- Peer Specialist
- Prineville, OR
National Provider Identifier
1013887363
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Peer Specialist
- License
- 112259
- Practice address
- 1333 NW 9TH St
Prineville, OR 97754-1482 - Phone
- (541) 447-2631
- NPI assigned
- Nov 10, 2025
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Peer Specialist | 175T00000X | 112259 | OR | Primary |
Addresses
Primary practice location
1333 NW 9TH St
Prineville, OR 97754-1482
Mailing address
1333 NW 9TH St
Prineville, OR 97754-1482
Phone (541) 447-2631
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 112259 | Other | OR | THW |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 112259 | OR | MD | Peer Specialist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1762732800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1762732800000",
"number": "1013887363",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1333 NW 9TH ST",
"city": "PRINEVILLE",
"state": "OR",
"postal_code": "977541482",
"telephone_number": "541-447-2631"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1333 NW 9TH ST",
"city": "PRINEVILLE",
"state": "OR",
"postal_code": "977541482",
"telephone_number": "541-447-2631"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STRADER",
"first_name": "CRYSTAL",
"middle_name": "ANN",
"credential": "PSS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2025-11-10",
"last_updated": "2025-11-10",
"certification_date": "2025-11-10",
"status": "A"
},
"taxonomies": [
{
"code": "175T00000X",
"taxonomy_group": "",
"desc": "Peer Specialist",
"state": "OR",
"license": "112259",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "THW",
"identifier": "112259",
"state": "OR"
}
],
"endpoints": [],
"other_names": []
}Other providers in Prineville, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.