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Deactivated NPI 1285820704 Deactivated / Inactive NPI Female Practitioner

Sandra Rustam , MA, LPCI

Counselor - Professional • Beaverton, OR

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Notice of NPI Deactivation & Inactive Practice Status

According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, Sandra Rustam has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date September 18, 2007
NPI Deactivation Date July 29, 2013
Total Practice Duration ~6 Years of Practice (2007 – 2013)

Professional Overview & Biography Verified Profile Summary

Sandra Rustam, MA, LPCI was a registered Counselor - Professional practicing in Beaverton, OR. Throughout an active medical career spanning 6 years, Sandra Rustam provided care at the practice location at 3601 SW MURRAY BLVD until profile deactivation on 2013-07-29.

Practice Location & Contact Primary Location

Practice Address

3601 Sw Murray Blvd
Suite 300

Beaverton, OR 970052354

Telephone 5037301790
Associated Practice Facility / Clinic
🏢 Providence West Home Health Facility NPI 1659548782

Specialty Benchmarks & Practice Insights

Comparative analytics for Counselor - Professional in Beaverton, OR

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.8 Yrs
State Avg: 13.7 Yrs
Regional Practice Density
102 Specialists

Practicing in Beaverton, OR (2601 Statewide)

Telehealth Adoption Rate
2.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

Counselor - Professional Primary Specialty

NUCC Taxonomy Code: 101YP2500X

Definition to come...

Counselor - Mental Health

NUCC Taxonomy Code: 101YM0800X

Definition to come...

Counselor - Addiction (Substance Use Disorder)

NUCC Taxonomy Code: 101YA0400X

Definition to come...

Health Maintenance Organization

NUCC Taxonomy Code: 302R00000X

(1) A form of health insurance in which its members prepay a premium for the HMO's health services which generally include inpatient and ambulatory care. For the patient, an HMO means reduced out-of-pocket costs (i.e. no deductible), no paperwork (i.e. insurance forms), and only a small copayment for each office visit to cover the paperwork handled by the HMO; (2) A organization of health care personnel and facilities that provides a comprehensive range of health services to an enrolled population for a fixed sum of money paid in advance for a specified period of time. These health services include a wide variety of medical treatments and consults, inpatient and outpatient hospitalization, home health service, ambulance service, and sometimes dental and pharmacy services. The HMO may be organized as a group model, an individual practice association (IPA), a network model or a staff model.

Community Based Residential Treatment Facility, Mental Illness

NUCC Taxonomy Code: 320800000X

A home-like residential facility providing psychiatric treatment and psycho/social rehabilitative services to individuals diagnosed with mental illness.

Counselor

NUCC Taxonomy Code: 101Y00000X

A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master's degree and clinical experience and supervision for licensure or certification.

Community/Behavioral Health

NUCC Taxonomy Code: 251S00000X

A private or public agency usually under local government jurisdiction, responsible for assuring the delivery of community based mental health, intellectual disabilities, substance abuse and/or behavioral health services to individuals with those disabilities. Services may range from companion care, respite, transportation, community integration, crisis intervention and stabilization, supported employment, day support, prevocational services, residential support, therapeutic and supportive consultation, environmental modifications, intensive in-home therapy and day treatment, in addition to traditional mental health and behavioral treatment.

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

4 Associated Practitioners
NPI 1205052511

Doctor of Pharmacy (Pharm.D.)

Cynthia Seger , RN BSN

Registered Nurse

NPI 1225360480

RNBSN

Dr. Christine Mayo Powers , PharmD

Pharmacist - Pharmacotherapy

NPI 1497062053

Doctor of Pharmacy (Pharm.D.)

NPI 1588091839

Doctor of Pharmacy (Pharm.D.)

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

7 Historical Events
📍
Updated Practice Location November 25, 2016

Registered at 3601 SW MURRAY BLVD, SUITE 300, BEAVERTON, OR 970052354 (Tel: 5037301790)

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Updated Business Mailing Address November 25, 2016

Registered at 14745 SW SANDHILL LOOP, SUITE 204, BEAVERTON, OR 970079079 (Tel: 5037301790)

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Provider Name / Credentials Updated November 25, 2016

Recorded as SANDRA RUSTAM, M.A., LPCI

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Medical Taxonomy / Specialty Registered (Primary Specialty) November 25, 2016

Counselor

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NPI Profile Reactivated November 17, 2016

Record officially reactivated for active practice on November 17, 2016

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NPI Profile Deactivated July 29, 2013

Record deactivated on July 29, 2013

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Initial NPI Registration & Enumeration September 18, 2007

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1285820704
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: September 18, 2007
Last Update: November 25, 2016
Deactivation Date: July 29, 2013
Sole Proprietor: Yes

Mailing Address

14745 Sw Sandhill Loop, Suite 204

Beaverton, OR 970079079

Phone: 5037301790

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.