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Individual

WILLIAM BACKUS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
3060 SE STARK ST, PORTLAND, OR 97214-3053
(503) 535-4700
Mailing address
25117 SW PARKWAY AVE, SUITE D, WILSONVILLE, OR 97070-9697

Taxonomy

Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
09127
OR

Other

Enumeration date
03/07/2015
Last updated
03/07/2015
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