Individual
SAMANTHA DECKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
1900 WOODLAND DR, COOS BAY, OR 97420-2099
(541) 267-5151
Mailing address
1900 WOODLAND DR, COOS BAY, OR 97420-2099
(541) 267-5151
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
823
HI
207N00000X
Dermatology Physician
Primary
PA197140
OR
Other
Enumeration date
04/07/2018
Last updated
03/02/2020
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