MEDICARE: MS. EMILY DECKER MS, CRC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101Y00000X	Counselor

General Provider Information

NPI Number	:	1184006546
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. EMILY DECKER MS, CRC

Provider Business Mailing Address
First Line	:	2645 PORTLAND RD NE STE 120
Second Line	:
City	:	SALEM
State	:	OR
Zip	:	97301-0200
Country	:	US
Telephone Number	:	503-390-5637
Fax Number	:

Provider Business Practice Location Address
First Line	:	1025 CONNECTICUT AVE NW STE 1000
Second Line	:
City	:	WASHINGTON
State	:	DC
Zip	:	20036-5417
Country	:	US
Telephone Number	:	202-309-2048
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/22/2015
Last Update Date	:	10/28/2019

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