Individual
JENELL R DECKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1125 SE WASHINGTON, PULLMAN, WA 99164-0001
(509) 335-6127
(509) 335-6223
Mailing address
140 N GRAND AVE, SUITE 1, PULLMAN, WA 99163
(509) 808-1933
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD60294725
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
64001423
—
KY
Enumeration date
03/08/2006
Last updated
09/28/2022
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