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Individual

KYLE NATHAN BACKER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
1615 DELAWARE ST, LONGVIEW, WA 98632-2367
(360) 636-8760
(360) 414-7599
Mailing address
PO BOX 232410, SAN DIEGO, CA 92193-2410
(800) 926-8273
(888) 539-8781

Taxonomy

Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
A155221
CA
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
MD61544789
WA

Other

Enumeration date
05/20/2014
Last updated
06/06/2024
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