Decker, Derwin
Decker, Derwin is an individual health care provider with primary practice located at 3949 South 6Th Street , Klamath Falls OR 97603-4746. He recently has only one registered license in Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder), which is considered as his primary health care specialty. Decker, Derwin can be contacted via phone (541) 882-1487.Contact Information
Primary practice address
3949 South 6Th Street
Klamath Falls OR 97603-4746
Phone: (541) 882-1487
Fax: (541) 882-1670
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) | 101YA0400X | 95-04-35 | Oregon |
Profile Details
| NPI number | 1619208337 |
|---|---|
| LBN Legal business name | Decker, Derwin |
| Credentials | CADC 1 |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jan 20th, 2010 |
| Last updated | Jan 20th, 2010 - about 14 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1619208337 | NPPES |
| Oregon | MEDICAID | 129861 |
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