Individual provider Active NPI

Kristell Marie Wade, CRNA

  • Certified Registered Nurse Anesthetist
  • Enterprise, OR
National Provider Identifier
1871503748
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
Practice address
604 Medical Parkway
Enterprise, OR 97828
Phone
(541) 426-5306
NPI assigned
Aug 9, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X OR
Certified Registered Nurse Anesthetist 367500000X OR Primary

Addresses

Primary practice location

604 Medical Parkway
Enterprise, OR 97828

Mailing address

79360 Wade Gulch Lane
Lostine, OR 97857
Phone (541) 263-1465

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR, WA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20191008001438 OR Practitioner - Certified Registered Nurse Anesthetist (Crna) 8123119146 Reassigns benefits to 4 organizations
I20220406002069 WA Practitioner - Certified Registered Nurse Anesthetist (Crna) 8123119146 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Medstream Anesthesia PLLCGroup PAC ID 7416198049, 571 clinicians
Grande Ronde Hospital IncGroup PAC ID 0547170789, 97 clinicians

Practice addresses (Care Compare)

3810 Plaza Way
Kennewick, WA 99338-2722
Phone (509) 221-7000

900 Sunset Dr
La Grande, OR 97850-1387
Phone (541) 963-8421

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
200260022CRNAORMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Grande Ronde Hospital, Inc. CurrentSince Dec 15, 2023 Accepting new patients
Medstream Anesthesia PLLC Nurse Anesthetist, Certified Registered CurrentSince Mar 25, 2022 Accepting new patients
Northwest Medical Foundation of Tillamook CurrentSince Jun 30, 2020 Accepting new patients
Wallowa County Health Care District Current Accepting new patients
Grande Ronde Hospital, Inc. CurrentSince Dec 15, 2023 Accepting new patients
Northwest Medical Foundation of Tillamook Current Accepting new patients
Northwest Medical Foundation of Tillamook CurrentSince Jun 30, 2020 Accepting new patients

Locations

601 Medical Pkwy
Enterprise, OR 97828
Phone (541) 426-3111

900 Sunset Dr
La Grande, OR 97850
Phone (541) 963-8421

1000 3rd St
#M
Tillamook, OR 97141
Phone (503) 815-2260

1000 3rd St
Tillamook, OR 97141
Phone (503) 251-6129

3810 Plaza Way
Kennewick, WA 99338
Phone (509) 221-7000

900 S Auburn St
Kennewick, WA 99336
Phone (509) 586-5111

Organizations & group practices 7

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1155081600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757548800000",
    "number": "1871503748",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "79360 WADE GULCH LANE",
            "city": "LOSTINE",
            "state": "OR",
            "postal_code": "97857",
            "telephone_number": "541-263-1465"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "604 MEDICAL PARKWAY",
            "city": "ENTERPRISE",
            "state": "OR",
            "postal_code": "97828",
            "telephone_number": "541-426-5306"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WADE",
        "first_name": "KRISTELL",
        "middle_name": "MARIE",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-09",
        "last_updated": "2025-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "OR",
            "license": null,
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "OR",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Enterprise, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.