Individual
MR. GERALD N BACKUS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MA
Contact information
Practice address
1500 NE IRVING ST, SUITE 250, PORTLAND, OR 97232-2243
(503) 233-4356
Mailing address
10441 SE COOK CT APT 385, MILWAUKIE, OR 97222-1535
(503) 206-7816
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
02/26/2007
Last updated
07/08/2007
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