DR. SERITA BACKSTRAND (NPI# 1265831705) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1265831705 |
| Entity Type | Individual |
| Full Name | DR. SERITA BACKSTRAND |
| Credential | PSY.D |
| Practice Address |
1791 Nw 173rd Ave Ste 140 Beaverton OR 97006 |
| Mailing Address |
1791 Nw 173rd Ave Ste 140 Beaverton OR 97006-5630 |
| Practice Telephone | 5035339806 |
| Practice Fax Number | 5033521809 |
| Mailing Telephone | 5035339806 |
| Mailing Fax Number | 5033521809 |
| Enumeration Date | 2014-08-21 |
| Last Update Date | 2019-04-01 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 103T00000X | Psychologist | PY60776565 | WA | Behavioral Health & Social Service Providers |
| Y | 103T00000X | Psychologist | 2933 | OR | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OR | 164936 | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 208 E 25th Street, Nw Family Psychology, LLC, Vancouver, WA 986633219 | 3609101522 | 3603261522 |
| Street Address |
1791 NW 173RD AVE STE 140 |
| City | BEAVERTON |
| State | OR |
| Zip Code | 97006 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942787601 | Christina Weiss | Psychologist | 1791 Nw 173rd Ave Ste 140, Beaverton, OR 97006-5630 | 2018-07-25 |
| 1902315765 | Stephanie Marie Conn | Psychologist | 1791 Nw 173rd Ave Ste 140, Beaverton, OR 97006-5630 | 2017-09-25 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184238727 | Hayden Alexander Meriwether | Dentist | 17895 Ne Evergreen Pkwy, #100, Beaverton, OR 97006 | 2020-09-01 |
| 1336781202 | Courtney Rae Murata | Behavior Technician | 337 Nw 215th Terrace, Apt, 106, Hillsboro, OR 97006 | 2019-10-11 |
| 1992355986 | Pamela J. Viado | Technician | 1220 Nw Weybridge Way, Beaverton, OR 97006 | 2019-09-12 |
| 1477115384 | One Change Group | Community/Behavioral Health | 2499 Nw 206th Ave, Apt A233, Hillsboro, OR 97006 | 2019-07-01 |
| 1649731332 | Regina C. Rizo | Social Worker | 1925 Amberglen Parkway, #3a-131, Hillsboro, OR 97006 | 2019-03-26 |
| 1043731912 | Elizabeth A Cintron | Occupational Therapy Assistant | 1189 Ne 89th Ave Apt 305, Hillsboro, OR 97006 | 2017-06-30 |
| 1265979173 | Lindsay Jensen | Massage Therapist | 15220 Nw Greenbrier Pkwy Ste 260, Beaverton, OR 97006 | 2017-01-30 |
| 1851835722 | Changepoint, Inc | Clinic/Center | 1700 Nw 167th Place, Suite 240, Beaverton, OR 97006 | 2016-12-13 |
| 1689126302 | Occupational Health Centers of The Southwest, P.a. (tx) | Clinic/Center | 2225 Nw Towncenter Drive, Beaverton, OR 97006 | 2016-10-28 |
| 1558717413 | Dillon Duvall | Physical Therapist | 16895 Nw Cornell Rd, #110, Beaverton, OR 97006 | 2016-05-10 |
| Find all providers in zip 97006 | ||||
| Taxonomy Code | 103T00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| A psychologist is an individual who is licensed to practice psychology which is defined as the observation, description, evaluation, interpretation, and modification of human behavior by the application of psychological principles, methods, and procedures, for the purpose of preventing or eliminating symptomatic, maladaptive, or undesired behavior and of enhancing interpersonal relationships, work and life adjustment, personal effectiveness, behavioral health, and mental health. The practice of psychology includes, but is not limited to, psychological testing and the evaluation or assessment of personal characteristics, such as intelligence, personality, abilities, interests, aptitudes, and neuropsychological functioning; counseling, psychoanalysis, psychotherapy, hypnosis, biofeedback, and behavior analysis and therapy; diagnosis and treatment of mental and emotional disorder or disability, alcoholism and substance abuse, disorders of habit or conduct, as well as of the psychological aspects of physical illness, accident, injury, or disability; and psycheducational evaluation, therapy, remediation, and consultation. Psychological services may be rendered to individuals, families, groups and the public. |
| Notes: Source: American Psychological Association [1/1/2007: modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740890771 | Marion David | Psychologist | 8228 Sw 171st Place, First Floor, Beaverton, OR 97007-6787 | 2020-08-04 |
| 1386028603 | Judith Lynne Auslander | Psychologist | 11855 Sw Ridgecrest Dr Ste 215, Beaverton, OR 97008-6356 | 2015-07-16 |
| 1962837591 | Swan Psychological and Counseling Services PC | Psychologist | 4900 Sw Griffith Dr Ste 161, Beaverton, OR 97005-4648 | 2013-09-13 |
| 1588813380 | Golnoush Monfared | Psychologist | 1915 Nw Amberglen Pkwy, Suite 400, Beaverton, OR 97006-6951 | 2008-09-17 |
| 1558496836 | Dale A Brounstein | Psychologist | 8196 Sw Hall Blvd Ste 102a, Beaverton, OR 97008-4676 | 2007-02-23 |
| 1295878239 | Mary Hacopian | Psychologist | 10700 Sw Beaverton Hillsdale Hwy Ste 450, Beaverton, OR 97005-4736 | 2007-02-15 |
| 1104965292 | James Arthur Soliday | Psychologist | 3861 Sw Hall Blvd, Beaverton, OR 97005-2049 | 2007-02-05 |
| 1699828020 | Karen Hernandez | Psychologist | 12750 Sw 2nd St, Suite 202, Beaverton, OR 97005-2778 | 2007-01-19 |
| 1376649905 | Shahana Koslofsky | Psychologist | 15455 Nw Greenbrier Pkwy Ste 240, Beaverton, OR 97006-8116 | 2006-09-14 |
| 1336162353 | Alex J Ricketts | Psychologist | 15985 Nw Schendel Ave, Beaverton, OR 97006-6489 | 2006-07-25 |
| Find all providers in BEAVERTON | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.