Individual provider Active NPI

Crystal Gregory

  • Peer Specialist
  • Vancouver, WA
National Provider Identifier
1407556764
Registry record updated Jan 7, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Peer SpecialistTaxonomy code 175T00000X
Practice address
6926 NE Fourth Plain Blvd
Vancouver, WA 98661-7254
Phone
(360) 993-3000
NPI assigned
Mar 6, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 7, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Doula 374J00000X BD61617720 WA
Peer Specialist 175T00000X Primary

Addresses

Primary practice location

6926 NE Fourth Plain Blvd
Vancouver, WA 98661-7254

Mailing address

6926 NE Fourth Plain Blvd
Vancouver, WA 98661-7254
Phone (360) 993-3000

Other practice location 1

100 E 33rd St Ste 100
Vancouver, WA 98663-2776
Phone (360) 762-9390

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address crystal@xchangelives.org

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
BD61617720WAMDDoula

Practice roles

OrganizationSpecialtyStatusNew patients
Xchange Behavioral Health Agency CurrentSince Mar 1, 2023 Accepting new patients
X Change Recovery Peer Specialist CurrentSince Mar 1, 2023 Accepting new patients

Locations

21810 NE 37th Ave
Ridgefield, WA 98642
Phone (844) 777-9242

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": "1678060800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736208000000",
    "number": "1407556764",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6926 NE FOURTH PLAIN BLVD",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986617254",
            "telephone_number": "360-993-3000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6926 NE FOURTH PLAIN BLVD",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986617254",
            "telephone_number": "360-993-3000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "100 E 33rd St Ste 100",
            "address_purpose": "LOCATION",
            "city": "Vancouver",
            "state": "WA",
            "postal_code": "986632776",
            "country_code": "US",
            "telephone_number": "360-762-9390",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GREGORY",
        "first_name": "CRYSTAL",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-03-06",
        "last_updated": "2025-01-07",
        "certification_date": "2025-01-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "374J00000X",
            "taxonomy_group": "",
            "desc": "Doula",
            "state": "WA",
            "license": "BD61617720",
            "primary": false
        },
        {
            "code": "175T00000X",
            "taxonomy_group": "",
            "desc": "Peer Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "crystal@xchangelives.org",
            "affiliation": "N",
            "address_1": "21810 NE 37th Ave",
            "city": "Ridgefield",
            "state": "WA",
            "country_code": "US",
            "postal_code": "986427747",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Vancouver, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 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.

Verify at the official NPI Registry.