Backstrand, Serita
Backstrand, Serita is an sole proprietor health care provider with primary practice located at 1791 Nw 173Rd Ave Ste 140 , Beaverton OR 97006. She recently has only one registered license in Behavioral Health & Social Service Providers / Psychologist, which is considered as her primary health care specialty. Backstrand, Serita can be contacted via phone (503) 533-9806.Contact Information
Primary practice address
1791 Nw 173Rd Ave Ste 140
Beaverton OR 97006
Phone: (503) 533-9806
Fax: (503) 352-1809
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Psychologist | 103T00000X | PY60776565 | Washington |
| Behavioral Health & Social Service Providers / Psychologist | 103T00000X | 2933 | Oregon |
Profile Details
| NPI number | 1265831705 |
|---|---|
| LBN Legal business name | Backstrand, Serita |
| Credentials | PSY.D |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Aug 21st, 2014 |
| Last updated | Apr 1st, 2019 - about 7 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1265831705 | NPPES |
| Oregon | MEDICAID | 164936 |
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