Healthcare Provider Details

I. General information

NPI: 1790181584
Provider Name (Legal Business Name): JILLIAN ANNE MALINAK LMHC, SUDP, NBCC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MISS JILLIAN ANNE WHITE

II. Dates (important events)

Enumeration Date: 11/06/2014
Last Update Date: 09/13/2026
Certification Date: 09/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 SE WASHINGTON AVE
CHEHALIS WA
98532-3058
US

IV. Provider business mailing address

1210 68TH AVE SE
TUMWATER WA
98501-5631
US

V. Phone/Fax

Practice location:
  • Phone: 360-748-4776
  • Fax:
Mailing address:
  • Phone: 360-748-4776
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License NumberCDP.CP.60690607
License Number StateWA
# 2
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberMHC.LH.61404251
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: