Serita Backstrand, PSY.D

Primary specialty

PsychologistTaxonomy code 103T00000X

License

2933 Issued in OR

Practice address

1791 NW 173Rd Ave Ste 140
Beaverton, OR 97006

Phone

(503) 533-9806

Fax

(503) 352-1809

NPI assigned

Aug 21, 2014

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective May 20, 2026 through May 20, 2028

Specialty

Clinical Psychologist

Education

Other, 2015

Medicare assignment

May accept Medicare assignment

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Western Psychological and Counseling Services LLC

  • Clinical Psychologist
  • Vancouver, WA
  • NPI 1629345731
  NPD
• Western Psychological and Counseling Services LLC

  • Clinical Psychologist
  • Tacoma, WA
  • NPI 1912008178
  NPD
• Harden Psychological Associates, P.C.

  • Clinical Psychologist
  • Hillsboro, OR
  • NPI 1831352632
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1408579200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1554076800000",
    "number": "1265831705",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1791 NW 173RD AVE STE 140",
            "city": "BEAVERTON",
            "state": "OR",
            "postal_code": "970065630",
            "telephone_number": "503-533-9806",
            "fax_number": "503-352-1809"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1791 NW 173RD AVE STE 140",
            "city": "BEAVERTON",
            "state": "OR",
            "postal_code": "97006",
            "telephone_number": "503-533-9806",
            "fax_number": "503-352-1809"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "208 E 25th Street",
            "address_2": "NW Family Psychology, LLC",
            "address_purpose": "LOCATION",
            "city": "Vancouver",
            "state": "WA",
            "postal_code": "986633219",
            "country_code": "US",
            "telephone_number": "360-910-1522 x3001",
            "fax_number": "360-326-1522",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BACKSTRAND",
        "first_name": "SERITA",
        "name_prefix": "Dr.",
        "credential": "PSY.D",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-08-21",
        "last_updated": "2019-04-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "WA",
            "license": "PY60776565",
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "OR",
            "license": "2933",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "164936",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ezra Azhar, MD
• Christine A Babinec, MA, LPC, NCC
• Tyler Baca
• Vanessa Baccellieri
• Back in Motion Sports Injuries Clinic, LLC
• Amelia Backus
• Robyn Aleen Baehler, LMT
• Jessica Anne Baele, PA-C
• Juliet Baele X, MD
• Sheyla Fernanda Baez

• Psychologist in Beaverton, OR
• Providers in Beaverton, OR by specialty
• Psychologist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.