Individual provider · Type 1 NPI

Sandra Rustam, M.A., LPCI

Professional Counselor · Beaverton, OR

NPI number 1285820704 Active · reactivated Nov 17, 2016

Practice location

3601 SW Murray Blvd, Suite 300
Beaverton, OR 97005-2354

Call (503) 730-1790 Map

Mailing address

14745 SW Sandhill Loop, Suite 204
Beaverton, OR 97007-9079

Specialties and licenses

TaxonomyCodeLicense
Addiction (Substance Use Disorder) Counselor 101YA0400XNone listed
Professional Counselor Primary 101YP2500XNone listed
Mental Health Counselor 101YM0800XNone listed
Community/Behavioral Health Agency 251S00000XNone listed
Health Maintenance Organization 302R00000XNone listed
Mental Illness Community Based Residential Treatment Facility 320800000XNone listed
Counselor 101Y00000XNone listed

Professional Counselor: Definition to come...

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About NPI 1285820704

Sandra Rustam, M.A., LPCI's National Provider Identifier is 1285820704, issued on Sep 18, 2007. The primary taxonomy on file is Professional Counselor (101YP2500X), and the practice location is in Beaverton, OR. The record was last updated on Nov 25, 2016.