Moonstone Mental Health

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

Legal business name

MOONSTONE MENTAL HEALTH

Practice address

7110 SW Fir Loop Ste 145
Tigard, OR 97223-8031

Phone

(503) 389-5882

NPI assigned

Jul 2, 2024

Last updated

Jan 20, 2025By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Jennie Peterson, MSNNPI 1144732918

Title

Pmhnp-BC

Phone

(503) 443-8339

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in OR

Enrollment records 1

Locations

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Jennie Michelle Peterson, PMHNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Beaverton, OR
  • NPI 1144732918
  Medicare reassignment NPD Authorized official
• Doris Mae Beard, MSW

  • Social Worker
  • Portland, OR
  • NPI 1124008495
  NPD (past)
• Katherine Marie Leonard, PHD

  • Psychologist
  • Portland, OR
  • NPI 1437203841
  NPD (past)
• Jane Post-Newman, LPC

  • Professional Counselor
  • Portland, OR
  • NPI 1023396728
  NPD (past)

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

{
    "created_epoch": "1719878400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1737331200000",
    "number": "1083450761",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7110 SW FIR LOOP STE 145",
            "city": "TIGARD",
            "state": "OR",
            "postal_code": "972238031",
            "telephone_number": "503-389-5882"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7110 SW FIR LOOP STE 145",
            "city": "TIGARD",
            "state": "OR",
            "postal_code": "972238031",
            "telephone_number": "503-389-5882"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOONSTONE MENTAL HEALTH",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-07-02",
        "last_updated": "2025-01-20",
        "certification_date": "2025-01-20",
        "status": "A",
        "authorized_official_last_name": "PETERSON",
        "authorized_official_first_name": "JENNIE",
        "authorized_official_title_or_position": "PMHNP-BC",
        "authorized_official_telephone_number": "503-443-8339",
        "authorized_official_credential": "MSN"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brittany Joy Monson, PHMNP
• Marisa Monteblanco, MSW, LCSW
• Carin G Montelongo, PA-C
• Nicholas George Mooberry, D.D.S.
• Kayla Moody, PA
• Chandrika M Moore, D.P.T
• Cotrell Moore
• Diane Calvin Moore, (M.A.) L.P.C.
• Heather Moore
• Heather M Moore, MD

• Psychiatric/Mental Health Nurse Practitioner in Tigard, OR
• Providers in Tigard, OR by specialty
• Psychiatric/Mental Health Nurse Practitioner in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 20, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.