Individual provider Active NPI

Ann Van Dreal, PSS

  • Peer Specialist
  • Salem, OR
National Provider Identifier
1265375687
Registry record updated Apr 10, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Peer SpecialistTaxonomy code 175T00000X
License
115627 Issued in OR
Practice address
4080 Reed Rd SE Ste 150
Salem, OR 97302-1335
Phone
(503) 581-1732
Fax
(503) 363-4607
NPI assigned
Apr 10, 2026
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 10, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Peer Specialist 175T00000X 115627 OR Primary

Addresses

Primary practice location

4080 Reed Rd SE Ste 150
Salem, OR 97302-1335

Mailing address

4080 Reed Rd SE Ste 150
Salem, OR 97302-1335
Phone (503) 581-1732

Other practice location 1

398 High St
Eugene, OR 97401-2310
Phone (541) 344-1121 ext. 101

Other names 1

  • Annie Van Dreal Other name

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

LicenseStateTypeSpecialty
115627ORMDPeer Specialist

Practice roles

OrganizationSpecialtyStatusNew patients
The Shangri-la Corporation Past Accepting new patients
The Shangri-la Corporation PastSince Jan 19, 2020 Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1775779200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1775779200000",
    "number": "1265375687",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4080 REED RD SE STE 150",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973021335",
            "telephone_number": "503-581-1732",
            "fax_number": "503-363-4607"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4080 REED RD SE STE 150",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973021335",
            "telephone_number": "503-581-1732",
            "fax_number": "503-363-4607"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "398 High St",
            "address_purpose": "LOCATION",
            "city": "Eugene",
            "state": "OR",
            "postal_code": "974012310",
            "country_code": "US",
            "telephone_number": "541-344-1121 x101",
            "fax_number": "541-344-4780",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VAN DREAL",
        "first_name": "ANN",
        "credential": "PSS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-04-10",
        "last_updated": "2026-04-10",
        "certification_date": "2026-04-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "175T00000X",
            "taxonomy_group": "",
            "desc": "Peer Specialist",
            "state": "OR",
            "license": "115627",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ANNIE",
            "last_name": "VAN DREAL",
            "credential": "PSS",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Salem, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.