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
Fax: (503) 352-1809
Website:

Health care specialties

SpecialtyCodeLicense #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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1265831705 NPPES
Oregon MEDICAID 164936

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