DR. SERITA BACKSTRAND PSY.D
NPI 1265831705
Psychologist in Beaverton, OR

Active since August 21, 2014Opted out of Medicare · through May 20, 2028
1791 NW 173RD AVE STE 140, BEAVERTON, OR 97006(503) 533-9806(503) 352-1809 Get Directions Write a Review

NPPES record last updated: April 1, 2019. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Apr 1, 2019, Apr 12, 2017 (2 updates tracked since 2017).

About Dr. Serita Backstrand Psy.d NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. SERITA BACKSTRAND PSY.D (NPI 1265831705) is an individual psychologist in Beaverton, Oregon, licensed in Oregon (2933) and active in the NPI registry since August 2014. She has opted out of Medicare through May 20, 2028, maintains a secondary practice location in Vancouver, and is a graduate of Other (2015).

NPPES Registry Identity

NPI1265831705
Entity TypeIndividualFemale
Primary Taxonomy103T00000X
Provider Legal NameDR. SERITA BACKSTRANDCredential: PSY.D
Location Address1791 NW 173RD AVE STE 140Beaverton, OR 97006
Mailing Address1791 Nw 173rd Ave Ste 140Beaverton, OR 97006-5630 · (503) 533-9806 · Fax (503) 352-1809
Fax(503) 352-1809
Sole ProprietorYes
Medical School CMSOtherGraduated 2015
Enumeration DateAugust 21, 2014
Last NPPES UpdateApril 1, 20192 updates tracked since enumeration
NPI 1265831705 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyPsychologistBehavioral Health & Social Service Providers
Taxonomy Code103T00000X
Licenses Licensed in OR · 2933 Licensed in WA · PY60776565
Definition
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.
1791 NW 173RD AVE STE 140, Beaverton, OR 97006

Secondary Practice Location 1

Location 1208 E 25th Street, NW Family Psychology, LLCVancouver, WA 98663-3219 · Phone (360) 910-1522 ext. 3001 · Fax (360) 326-1522

Other Identifiers 1

Medicaid164936OR

Accepted Insurance

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

Opted out of Medicare

Dr. Serita Backstrand Psy.d has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from May 20, 2026 through May 20, 2028.

Opt-Out Effective DateMay 20, 2026
Opt-Out In Effect ThroughMay 20, 2028Opt-out affidavits renew automatically every two years unless cancelled

Other Providers at the Same Location NPPES 3

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Counselor (Mental Health)
1791 NW 173RD AVE STE 140
BEAVERTON, OR 97006
Psychologist
1791 NW 173RD AVE STE 140
BEAVERTON, OR 97006
Psychologist (Clinical)
1791 NW 173RD AVE STE 140
BEAVERTON, OR 97006

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Serita Backstrand's NPI number?

The NPI number for Serita Backstrand is 1265831705. It was assigned to this individual provider in the NPPES registry on August 21, 2014.

Where is Serita Backstrand located?

Serita Backstrand practices at 1791 NW 173rd Ave Ste 140, Beaverton, OR 97006. The listed phone number is (503) 533-9806.

What is Serita Backstrand's specialty?

The primary specialty registered for this NPI is Psychologist with taxonomy code 103T00000X.

Is Serita Backstrand enrolled in Medicare?

No. Serita Backstrand has opted out of Medicare through May 20, 2028. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out.

What insurance does Serita Backstrand accept?

Health plans from BridgeSpan Health Company, Kaiser Permanente, Moda Health Plan, Inc., PacificSource Health Plans and Providence Health Plan and 1 other insurer list Serita Backstrand as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Serita Backstrand was last updated on April 1, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.