First Moon Isabelle Venecia
Counselor, Mental Health in Portland, OR. Individual provider (NPI-1).
NPI number1073449682
StatusActive
Last updated in NPPESJun 22, 2026
Details
- NPI
- 1073449682
- Entity type
- Individual (NPI-1)
- Name
- First Moon Isabelle Venecia
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Jun 22, 2026
- Certification date
- Jun 22, 2026
- Last updated
- Jun 22, 2026
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 101YM0800X | Counselor, Mental Health | – | – | Yes |
Practice location
5331 S Macadam Ave Ste 287Portland, OR 97239-3849
Phone 503-635-3416
Mailing address
5331 S Macadam Ave Ste 287Portland, OR 97239-3849
Phone 503-635-3416
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