Newly Listed Provider — this NPI profile has been added to the NPI registry within the last 90 days.

OVER THE MOON PSYCHIATRY LLC
NPI 1689578676
Nurse Practitioner - Psychiatric/Mental Health in Portland, OR

Q: What is Over The Moon Psychiatry LLC's NPI number?

The NPI number for Over The Moon Psychiatry LLC is 1689578676. It was assigned to this organization in the NPPES registry on October 5, 2026.

Q: What is Over The Moon Psychiatry LLC's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Psychiatric/Mental Health, with taxonomy code 363LP0808X.

Active since October 05, 2026

7573 N EDGEWATER AVE, PORTLAND, OR 97203(915) 319-0828 Get Directions Write a Review

NPPES record added: October 5, 2026. Verified against the NPPES registry weekly; last sync: October 11, 2026.

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About Over The Moon Psychiatry Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

OVER THE MOON PSYCHIATRY LLC (NPI 1689578676) is a healthcare organization registered as a psychiatric/mental health in Portland, Oregon and active in the NPI registry since October 2026. The organization lists Jacob Joseph Tullius, Owner, as its authorized official.

NPPES Registry Identity

NPI1689578676

Entity TypeOrganization

Primary Taxonomy363LP0808X

Legal Business NameOVER THE MOON PSYCHIATRY LLC

Location Address7573 N EDGEWATER AVEPortland, OR 97203-5081

Mailing Address7573 N Edgewater AvePortland, OR 97203-5081 · (915) 319-0828

Phone(915) 319-0828

Organization SubpartNo

Authorized OfficialJacob Joseph TulliusOwner · (915) 319-0828

Enumeration DateOctober 5, 2026

NPPES CertifiedOctober 5, 2026

✔ NPI 1689578676 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · Psychiatric/Mental HealthPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LP0808X

7573 N EDGEWATER AVE, Portland, OR 97203

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Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MR. JACOB JOSEPH TULLIUS

Nurse Practitioner (Psychiatric/Mental Health)

7573 N EDGEWATER AVE
PORTLAND, OR 97203

Multnomah County (915) 319-0828

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Over The Moon Psychiatry LLC's NPI number?

The NPI number for Over The Moon Psychiatry LLC is 1689578676. It was assigned to this organization in the NPPES registry on October 5, 2026.

Where is Over The Moon Psychiatry LLC located?

Over The Moon Psychiatry LLC is located at 7573 N Edgewater Ave, Portland, OR 97203. The listed phone number is (915) 319-0828.

What is Over The Moon Psychiatry LLC's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Psychiatric/Mental Health, with taxonomy code 363LP0808X.

When was this NPI record last updated?

The NPPES record for Over The Moon Psychiatry LLC was last updated on October 5, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 days ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.