Jessica Rose Malstrom, CADCI, B.A.

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

Practice address

9670 SW Beaverton Hillsdale Hwy
Annex B
Beaverton, OR 97005-3307

Phone

(503) 626-9494

Fax

(503) 646-8401

NPI assigned

Aug 14, 2007

Last updated

May 8, 2013By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Ms. Jessica Rose Bonar Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Bachelor of Arts

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1187049600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1367971200000",
    "number": "1619169695",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9670 SW BEAVERTON HILLSDALE HWY",
            "address_2": "ANNEX B",
            "city": "BEAVERTON",
            "state": "OR",
            "postal_code": "970053307",
            "telephone_number": "503-626-9494",
            "fax_number": "503-646-8401"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9670 SW BEAVERTON HILLSDALE HWY",
            "address_2": "ANNEX B",
            "city": "BEAVERTON",
            "state": "OR",
            "postal_code": "970053307",
            "telephone_number": "503-626-9494",
            "fax_number": "503-646-8401"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MALSTROM",
        "first_name": "JESSICA",
        "middle_name": "ROSE",
        "name_prefix": "Mrs.",
        "credential": "CADCI, B.A.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-08-14",
        "last_updated": "2013-05-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "195164",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JESSICA",
            "last_name": "BONAR",
            "middle_name": "ROSE",
            "prefix": "MS.",
            "credential": "CADCI, BA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Tony Arlyn Maldonado, HAS
• Ariel Tessa Malia, LPC
• Joseph F Mallari, LMT
• Marlene Malone
• Steven Malone
• Melanie B Mamola, PROF.COUNSELOR ASS.
• Jenna Elizabeth Mamula, M. S., CCC-SLP
• Scott Harlow Mandel, M.D.
• Danielle Nicole Mandley
• Megan Manley, PA-C

• Addiction (Substance Use Disorder) Counselor in Beaverton, OR
• Providers in Beaverton, OR by specialty
• Addiction (Substance Use Disorder) Counselor in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.