Individual
MS. KATELYN DECKER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
L.AC., M.AC.O.M.
Contact information
Practice address
130 NW MILLER AVE, GRESHAM, OR 97030-7226
(503) 568-1646
(833) 603-1296
Mailing address
2627 NE BROADWAY ST, PORTLAND, OR 97232-1720
(971) 235-1171
Taxonomy
Speciality
Code
Description
License number
State
171100000X
Acupuncturist
Primary
150593
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500650081
—
OR
Enumeration date
01/27/2010
Last updated
02/04/2021
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