NPI 1124525043 · live from the CMS NPI Registry
Samantha Decker, PA
Dermatology in Coos Bay, OR. National Provider Identifier 1124525043, active.
NPI record
| NPI | 1124525043 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Dermatology 207N00000X |
| Practice location | 1900 Woodland Dr, Coos Bay, OR 97420 |
| Practice phone | 541-267-5151 |
| Enumerated | April 7, 2018 |
| Last updated | March 2, 2020 |
| Sole proprietor | No |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Dermatology primary | 207N00000X | PA197140 (OR) |
| Dermatology | 207N00000X | 823 (HI) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.