Basic Information
| Provider Information | |||||||||
| NPI: | 1629275060 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | BACKER | ||||||||
| FirstName: | MARTIN | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3800 SUMMITVIEW AVE | ||||||||
| Address2: | |||||||||
| City: | YAKIMA | ||||||||
| State: | WA | ||||||||
| PostalCode: | 989022715 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5092483263 | ||||||||
| FaxNumber: | 5092252702 | ||||||||
| Practice Location | |||||||||
| Address1: | 4003 CREEKSIDE LOOP | ||||||||
| Address2: | |||||||||
| City: | YAKIMA | ||||||||
| State: | WA | ||||||||
| PostalCode: | 989083959 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5092483263 | ||||||||
| FaxNumber: | 5092252702 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/29/2007 | ||||||||
| LastUpdateDate: | 02/22/2021 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 02/22/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | MD60200238 | WA | N | Allopathic & Osteopathic Physicians | Internal Medicine | 207RI0200X | MD60200238 | WA | N | Allopathic & Osteopathic Physicians | Internal Medicine | Infectious Disease | 208000000X | MD60200238 | WA | N | Allopathic & Osteopathic Physicians | Pediatrics | 207RI0200X | 301387 | NY | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Infectious Disease |
No ID Information.