Provider Demographics
NPI:1790835676
Name:MALJAI, KARI L (MA)
Entity Type:Individual
Prefix:MS
First Name:KARI
Middle Name:L
Last Name:MALJAI
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6674 SE MILWAUKIE AVE
Mailing Address - Street 2:SUITE B210
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97202-5616
Mailing Address - Country:US
Mailing Address - Phone:971-258-2120
Mailing Address - Fax:971-200-2719
Practice Address - Street 1:6674 SE MILWAUKIE AVE
Practice Address - Street 2:SUITE B210
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97202-5616
Practice Address - Country:US
Practice Address - Phone:971-258-2120
Practice Address - Fax:971-200-2719
Is Sole Proprietor?:No
Enumeration Date:2007-01-11
Last Update Date:2016-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORC3200101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health