Individual
SANDRA RUSTAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.A., LPCI
Contact information
Practice address
3601 SW MURRAY BLVD, SUITE 300, BEAVERTON, OR 97005-2354
(503) 730-1790
Mailing address
14745 SW SANDHILL LOOP, SUITE 204, BEAVERTON, OR 97007-9079
(503) 730-1790
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
101YM0800X
Mental Health Counselor
—
—
101YP2500X
Professional Counselor
Primary
—
—
251S00000X
Community/Behavioral Health Agency
—
—
302R00000X
Health Maintenance Organization
—
—
320800000X
Mental Illness Community Based Residential Treatment Facility
—
—
Other
Enumeration date
09/18/2007
Last updated
11/25/2016
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us