Organization Active NPI

La Lune Integrative Psychiatry PLLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Spokane, WA
National Provider Identifier
1457094575
Registry record updated Apr 16, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
Legal business name
LA LUNE INTEGRATIVE PSYCHIATRY PLLC
Practice address
522 W Riverside Ave Ste 4117
Spokane, WA 99201-0580
Phone
(206) 531-7844
Fax
(503) 386-3252
NPI assigned
Apr 16, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 16, 2022

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

Authorized official

Name
Ms. Elita Wong, NP
Title
Owner, Nurse Practitioner
Phone
(206) 531-7844

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LP0808X Primary

Addresses

Primary practice location

522 W Riverside Ave Ste 4117
Spokane, WA 99201-0580

Mailing address

522 W Riverside Ave Ste 4117
Spokane, WA 99201-0580
Phone (206) 531-7844

Other identifiers 1

IdentifierTypeStateIssuer
AP61085917OtherWASTATE LICENSE

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL joinlalune.com Direct

National Provider Directory

National Provider Directory

Locations

522 W Riverside Ave
Ste 4117
Spokane, WA 99201
Phone (206) 531-7844

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1650067200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1650067200000",
    "number": "1457094575",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "522 W RIVERSIDE AVE STE 4117",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992010580",
            "telephone_number": "206-531-7844",
            "fax_number": "503-386-3252"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "522 W RIVERSIDE AVE STE 4117",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992010580",
            "telephone_number": "206-531-7844",
            "fax_number": "503-386-3252"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LA LUNE INTEGRATIVE PSYCHIATRY PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-04-16",
        "last_updated": "2022-04-16",
        "certification_date": "2022-04-16",
        "status": "A",
        "authorized_official_last_name": "WONG",
        "authorized_official_first_name": "ELITA",
        "authorized_official_title_or_position": "OWNER, NURSE PRACTITIONER",
        "authorized_official_telephone_number": "206-531-7844",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "NP"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "AP61085917",
            "state": "WA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "joinlalune.com",
            "affiliation": "N",
            "endpointDescription": "HIPAA compliant application",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "HIPAA compliant application",
            "address_1": "522 W Riverside Ave Ste 4117",
            "city": "Spokane",
            "state": "WA",
            "country_code": "US",
            "postal_code": "992010580",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Spokane, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 2022; 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.