MEDICARE: MS. KARI L MALJAI MA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor	C3200	OR

General Provider Information

NPI Number	:	1790835676
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. KARI L MALJAI MA

Provider Business Mailing Address
First Line	:	6674 SE MILWAUKIE AVE
Second Line	:	SUITE B210
City	:	PORTLAND
State	:	OR
Zip	:	97202-5616
Country	:	US
Telephone Number	:	971-258-2120
Fax Number	:	971-200-2719

Provider Business Practice Location Address
First Line	:	6674 SE MILWAUKIE AVE
Second Line	:	SUITE B210
City	:	PORTLAND
State	:	OR
Zip	:	97202-5616
Country	:	US
Telephone Number	:	971-258-2120
Fax Number	:	971-200-2719

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/11/2007
Last Update Date	:	11/28/2016

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