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1083450761
MOONSTONE MENTAL HEALTH LLC
TIGARD, OR
NPI
1083450761
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Entity Type
Organization
Authorized Contact
JENNIE PETERSON
Pmhnp Bc
503-443-8339
Organization Subpart ?
No
Primary Taxonomy
363LP0808X Nurse Practitioner, Psych/Mental Health
Enumeration Date
2024-07-02
Last Update Date
2024-07-02
Business Address
MOONSTONE MENTAL HEALTH LLC
7110 SW FIR LOOP STE 145
TIGARD, OR 97223-8031
Phone number: 503-389-5882
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Mailing Address
MOONSTONE MENTAL HEALTH LLC
7110 SW FIR LOOP STE 145
TIGARD, OR 97223-8031
Phone number: 503-389-5882
Copy
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