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Contact Information

MARY D BACKSTROM, RN
1200 E COLUMBIA AVE
COLVILLE, WA99114-3354
 Phone: 509-684-3701
 Fax: 509-684-5817
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Diabetes Educator

163WD0400X
Indicates primary specialty

NPI Profile & details for MARY D BACKSTROM · (Female)

NPI # 1568444628
Status Active
Credentials RN (Registered Nurse)
Entity Individual
Enumeration date 11/15/2005
Last updated 07/08/2007 - About 19 years ago
Sole proprietor 1 Not specified
Identifiers
  • WA License # RN00130472
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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