Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LG0600X | Nurse Practitioner - Gerontology | AP60795141 | WA |
NPI | 1013257013 |
---|---|
Provider Name | Maria Rachelle Decker |
First Address | Wenatchee, WA 98801-2028 |
Second Address | Wenatchee, WA 98801-2028 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/02/2013 |
Last Update Date | 10/05/2021 |