DR. DIANE WADIAK BACKUS (NPI# 1942341847) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1942341847 |
| Entity Type | Individual |
| Full Name | DR. DIANE WADIAK BACKUS |
| Credential | PH.D. |
| Practice Address |
1012 Sw Emkay Dr Bend OR 97702-1010 |
| Practice Telephone | 5416170024 |
| Mailing Telephone | 5416170024 |
| Enumeration Date | 2007-02-12 |
| Last Update Date | 2007-07-08 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103TC0700X |
Psychologist Specialization: Clinical |
1468 | OR | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OR | REGENCE BLUE CROSS BLUE S | 808489000 | 01 |
| Street Address |
1012 SW EMKAY DR |
| City | BEND |
| State | OR |
| Zip Code | 97702-1010 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053482109 | Judith K Clements | Psychologist | 1012 Sw Emkay Dr, Bend, OR 97702-1010 | 2006-11-12 |
| 1831498922 | Gertler & Gertler P.C. | Psychologist | 1012 Sw Emkay Dr, Bend, OR 97702-1010 | 2011-03-15 |
| 1942432018 | Ellen M Eisman | Psychologist | 1012 Sw Emkay Dr, Bend, OR 97702-1010 | 2009-08-21 |
| 1629100334 | Alan Werkman | Social Worker | 1012 Sw Emkay Dr, Bend, OR 97702-1010 | 2007-03-09 |
| 1487796512 | Julie Lynn King | Psychologist | 1012 Sw Emkay Dr, Bend, OR 97702-1010 | 2007-02-13 |
| 1891855300 | David Goldstein | Psychologist | 1012 Sw Emkay Dr, Bend, OR 97702-1010 | 2006-12-12 |
| 1568534105 | Ray Gertler | Psychologist | 1012 Sw Emkay Dr, Bend, OR 97702-1010 | 2006-11-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629676259 | Amy Michelle Anderson | Counselor | 233 Sw Wilson Ave, Ste 201, Bend, OR 97702 | 2020-10-15 |
| 1386259463 | Jacob Rehder | Counselor | 19717 Mt Batchelor Dr, #226, Bend, OR 97702 | 2020-09-15 |
| 1497385215 | Capacity Performance Therapy | Physical Medicine & Rehabilitation | 61125 Lodgepole Dr., Bend, OR 97702 | 2020-01-21 |
| 1962041707 | Shift Bend Functional Medicine | Family Medicine | 151 Sw Shevlin Hicks Dr, Suite #1, Bend, OR 97702 | 2019-12-26 |
| 1609435049 | Praxis Medical Group Inc | Orthopaedic Surgery | 1140 Sw Simpson Avenue, Suite 100, Bend, OR 97702 | 2019-06-10 |
| 1013485754 | Elana Leah Pesah | Social Worker | 138 Maaglei Harim Levin, Jerusalem, ISRAEL 97702 | 2018-11-12 |
| 1104303239 | Kyleigh Mcvey | Massage Therapist | 999 Sw Disk Dr, Bend, OR 97702 | 2018-07-21 |
| 1477042869 | Siloe Castaneda Huerta | Counselor | 1340 Nw Wall, Bend, Or, Bend, OR 97702 | 2018-05-02 |
| 1164910808 | Rebecca M Joyce | Social Worker | 1011 Sw Emkay Dr. Suite 101, Bend, OR 97702 | 2018-04-27 |
| 1093217978 | Jennifer Bury | Acupuncturist | 296 Sw Columbia St Ste D1, Bend, OR 97702 | 2018-03-06 |
| Find all providers in zip 97702 | ||||
| Taxonomy Code | 103TC0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Clinical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780992305 | Cassie Laurel O'brien | Psychologist | 45 Nw Greeley Ave, Bend, OR 97703-2943 | 2010-09-16 |
| 1326352063 | David J. Kleber | Psychologist | 384 Sw Upper Terrace Dr., Suite 209, Bend, OR 97702 | 2010-08-05 |
| 1962735746 | Kathleen Ann Hoyt | Psychologist | 855 Sw Yates Dr, Suite 101, Bend, OR 97702-3217 | 2009-09-11 |
| 1083859235 | Robert F Burch Phd PC | Psychologist | 390 Sw Columbia St Ste 210, Bend, OR 97702-3227 | 2008-12-02 |
| 1700085792 | John Vincent Prignano | Psychologist | 635 Nw Colorado Ave, Bend, OR 97701-3257 | 2007-07-11 |
| 1730384975 | Bruce W. Bundy, Psyd, PC | Psychologist | 205 Se Davis Ave Ste A, Bend, OR 97702-1333 | 2007-06-18 |
| 1386849941 | Frances F Miller | Psychologist | 548 Nw Greyhawk, Bend, OR 97701 | 2007-06-15 |
| 1841402872 | Michael Grayson Conner | Psychologist | 965 Ne Wiest Way, Bend, OR 97701-4285 | 2007-05-03 |
| 1851423776 | Michelle Whitehead | Psychologist | 26 Nw Irving, Bend, OR 97701 | 2007-03-09 |
| 1356485734 | Linda Jane Schrader-patton | Psychologist | 731 Nw Franklin Ave Ste 103, Bend, OR 97701-2752 | 2007-02-17 |
| Find all providers in BEND | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.