NPI 1306862388 · live from the CMS NPI Registry
Jennifer Backman, DO
Family Medicine in Kellogg, ID. National Provider Identifier 1306862388, active.
NPI record
| NPI | 1306862388 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Family Medicine 207Q00000X |
| Practice location | 25 Jacobs Gulch Rd, Kellogg, ID 83837 |
| Practice phone | 208-784-1221 |
| Mailing address | 2051 Kaen Rd, Suite 367, Oregon City, OR 97045 |
| Enumerated | July 14, 2006 |
| Last updated | May 5, 2025 |
| Sole proprietor | Yes |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Family Medicine | 207Q00000X | DO25595 (OR) |
| Family Medicine primary | 207Q00000X | O-1192 (ID) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.