Kyle Kathleen Moon

Primary specialty

CounselorTaxonomy code 101Y00000X

Practice address

3601 W 10TH St
The Dalles, OR 97058-4377

Phone

(503) 234-9591

NPI assigned

Jan 12, 2017

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1484179200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694736000000",
    "number": "1144766221",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3415 SE POWELL BLVD",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972023371",
            "telephone_number": "503-234-9591"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3601 W 10TH ST",
            "city": "THE DALLES",
            "state": "OR",
            "postal_code": "970584377",
            "telephone_number": "503-234-9591"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "500 Fairway Dr Ste 102",
            "address_purpose": "LOCATION",
            "city": "Deerfield Beach",
            "state": "FL",
            "postal_code": "334411817",
            "country_code": "US",
            "telephone_number": "877-418-2978",
            "fax_number": "866-500-2186",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1260 Morena Blvd",
            "address_purpose": "LOCATION",
            "city": "San Diego",
            "state": "CA",
            "postal_code": "921103889",
            "country_code": "US",
            "telephone_number": "619-398-0355",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MOON",
        "first_name": "KYLE",
        "middle_name": "KATHLEEN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-01-12",
        "last_updated": "2023-09-15",
        "certification_date": "2023-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ann Marie Minihane, LCSW
• Marti L Mitchell, DO
• Mobility Systems LLC
• Cheryl Mojzer
• Shantill Lynn Moody
• Paul Oh Sung Moon, M.D.
• Jessica Moore
• Kathleen Baker Moore, M.D.
• Elizabeth A Morales Davila
• Mireya Moreno Ibarra

• Counselor in The Dalles, OR
• Providers in The Dalles, OR by specialty
• Counselor in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2023; 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.