Individual
MRS. JESSICA ROSE MALSTROM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CADCI, B.A.
Contact information
Practice address
9670 SW BEAVERTON HILLSDALE HWY, ANNEX B, BEAVERTON, OR 97005-3307
(503) 626-9494
(503) 646-8401
Mailing address
9670 SW BEAVERTON HILLSDALE HWY, ANNEX B, BEAVERTON, OR 97005-3307
(503) 626-9494
(503) 646-8401
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
195164
—
OR
Enumeration date
08/14/2007
Last updated
05/08/2013
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