Decker, Katelyn
Decker, Katelyn is an sole proprietor health care provider with primary practice located at 130 Nw Miller Ave , Gresham OR 97030-7226. She recently has only one registered license in Other Service Providers / Acupuncturist, which is considered as her primary health care specialty. Decker, Katelyn can be contacted via phone (503) 568-1646.Contact Information
Primary practice address
130 Nw Miller Ave
Gresham OR 97030-7226
Phone: (503) 568-1646
Fax: (833) 603-1296
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Other Service Providers / Acupuncturist | 171100000X | 150593 | Oregon |
Profile Details
| NPI number | 1235460494 |
|---|---|
| LBN Legal business name | Decker, Katelyn |
| Credentials | L.AC., M.AC.O.M. |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jan 27th, 2010 |
| Last updated | Feb 4th, 2021 - about 3 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 | 1235460494 | NPPES |
| Oregon | MEDICAID | 500650081 |
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