Provider Demographics
NPI:1548734478
Name:REDDINGTON, CRYSTAL ANNETTE (THW)
Entity type:Individual
Prefix:
First Name:CRYSTAL
Middle Name:ANNETTE
Last Name:REDDINGTON
Suffix:
Gender:F
Credentials:THW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:47767 NW PONGRATZ RD
Mailing Address - Street 2:
Mailing Address - City:BANKS
Mailing Address - State:OR
Mailing Address - Zip Code:97106-7502
Mailing Address - Country:US
Mailing Address - Phone:541-228-6757
Mailing Address - Fax:
Practice Address - Street 1:47767 NW PONGRATZ RD
Practice Address - Street 2:
Practice Address - City:BANKS
Practice Address - State:OR
Practice Address - Zip Code:97106-7502
Practice Address - Country:US
Practice Address - Phone:541-228-6757
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-01-14
Last Update Date:2025-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No171M00000XOther Service ProvidersCase Manager/Care Coordinator