| Moonwell Therapy Llc | |
|
4721 Sw 45th Ave Portland OR 97221-3620 | |
| (512) 900-7602 | |
| Not Available |
| Full Name | Moonwell Therapy Llc |
|---|---|
| Speciality | Counselor - Mental Health |
| Location | 4721 Sw 45th Ave, Portland, Oregon |
| Authorized Official Name and Position | Shabd K Khalsa (OWNER/LPC) |
| Authorized Official Contact | 5126897173 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Moonwell Therapy Llc 4721 Sw 45th Ave Portland OR 97221-3620 Ph: (512) 900-7602 | Moonwell Therapy Llc 4721 Sw 45th Ave Portland OR 97221-3620 Ph: (512) 900-7602 |
| NPI Number | 1841167103 |
|---|---|
| Provider Enumeration Date | 10/21/2025 |
| Last Update Date | 10/21/2025 |
| Certification Date | 10/21/2025 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1841167103 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
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