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General NPI Number Information
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NPI Number | 1710854070
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Entity Type | Organization
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Legal Business Name | MOONSTONE MIDWIFERY, LLC
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Dates
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Enumeration Date | 10/21/2025
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Last Update Date | 10/21/2025
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Provider Practice Location Address
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Address Line | 584 JAMES ST
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City | TALENT
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State | OR
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Zip | 97540-9764
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Country | US
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Telephone | 541-621-6315
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Fax | 888-543-0682
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Provider Business Mailing Address
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Address Line | 584 JAMES ST
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City | TALENT
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State | OR
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Zip | 97540-9764
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Country | US
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Telephone | 541-621-6315
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Fax | 888-543-0682
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Authorized Official
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Title or Position | OWNER, MIDWIFE
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Name | JESSICA SIOUX RUEDIGER
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Credential | LDM, CPM, IBCLC
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Telephone | 541-621-6315
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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