Individual
CARRIE DECKER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
1143 LONG RIDGE DR, SPRINGFIELD, OR 97478-8504
(541) 912-7673
Mailing address
1143 LONG RIDGE DR, SPRINGFIELD, OR 97478-8504
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
201702895LPN
OR
Other
Enumeration date
05/02/2017
Last updated
05/02/2017
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