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General NPI Number Information
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NPI Number | 1346152170
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Entity Type | Organization
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Legal Business Name | ROOST PERINATAL
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Dates
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Enumeration Date | 09/17/2026
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Last Update Date | 09/17/2026
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Provider Practice Location Address
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Address Line | 6845 NE GARFIELD AVE
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City | PORTLAND
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State | OR
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Zip | 97211-2913
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Country | US
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Telephone | 503-929-9515
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Fax |
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Provider Business Mailing Address
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Address Line | 6845 NE GARFIELD AVE
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City | PORTLAND
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State | OR
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Zip | 97211-2913
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Country | US
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Telephone | 503-929-9515
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Fax |
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Authorized Official
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Title or Position | CO-FOUNDER
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Name | JESSA MOON
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Credential |
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Telephone | 503-929-9515
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163WL0100X
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Taxonomy Name | Lactation Consultant (Registered Nurse)
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 174H00000X
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Taxonomy Name | Health Educator
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 174N00000X
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Taxonomy Name | Lactation Consultant (Non-RN)
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 176B00000X
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Taxonomy Name | Midwife
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 374J00000X
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Taxonomy Name | Doula
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License Number |
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License Number State |
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