Pacific Northwest Teletherapy

Primary specialty

Adult Mental Health Clinic/CenterTaxonomy code 261QM0850X

Legal business name

PACIFIC NORTHWEST TELETHERAPY

Practice address

5441 S Macadam Ave Ste 8054
Portland, OR 97239-6106

Phone

(503) 383-9225

NPI assigned

Jul 24, 2024

Organization subpart

No

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

Authorized official

Name

Emma Moon, LCSWNPI 1245514983

Title

Owner

Phone

(503) 383-9225

Specialties & licenses 1

Addresses

Practitioners 1

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

• Emma Moon, LCSW

  • Clinical Social Worker
  • Portland, OR
  • NPI 1245514983
  NPD Authorized official

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

{
    "created_epoch": "1721779200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1775606400000",
    "number": "1740018399",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5441 S MACADAM AVE STE 8054",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972396106",
            "telephone_number": "503-383-9225",
            "fax_number": "458-234-4341"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5441 S MACADAM AVE STE 8054",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972396106",
            "telephone_number": "503-383-9225"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PACIFIC NORTHWEST TELETHERAPY",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-07-24",
        "last_updated": "2026-04-08",
        "certification_date": "2026-04-08",
        "status": "A",
        "authorized_official_last_name": "MOON",
        "authorized_official_first_name": "EMMA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "503-383-9225",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Pacific Northwest Psychological Services
• Pacific Northwest Renal Services, L.L.C.
• Pacific Northwest Renal Services, L.L.C.
• Pacific Northwest Renal Services, L.L.C.
• Pacific Northwest Renal Services, L.L.C.
• Pacific Northwest Wellness LLC
• Pacific Nutrition Collective LLC
• Pacific O&P LLC
• Pacific Oncology PC
• Pacific Premier Group, PC

• Adult Mental Health Clinic/Center in Portland, OR
• Providers in Portland, OR by specialty
• Adult Mental Health Clinic/Center in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 2026; 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.