Malstrom, Jessica Rose

Malstrom, Jessica Rose is an individual health care provider with primary practice located at 9670 Sw Beaverton Hillsdale Hwy Annex B, Beaverton OR 97005-3307. She recently has only one registered license in Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder), which is considered as her primary health care specialty. Malstrom, Jessica Rose can be contacted via phone (503) 626-9494.

Contact Information

Primary practice address
9670 Sw Beaverton Hillsdale Hwy Annex B Beaverton OR 97005-3307
Phone: (503) 626-9494
Fax: (503) 646-8401
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) 101YA0400X

Profile Details

NPI number 1619169695
LBN Legal business name Malstrom, Jessica Rose
Credentials CADCI, B.A.
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 14th, 2007
Last updated May 8th, 2013 - about 12 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1619169695 NPPES
Oregon MEDICAID 195164

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