Provider Demographics
NPI:1427319177
Name:DECKER, JAMES WINFIELD (PHARMACIST)
Entity type:Individual
Prefix:MR
First Name:JAMES
Middle Name:WINFIELD
Last Name:DECKER
Suffix:
Gender:M
Credentials:PHARMACIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5639 HOOD ST
Mailing Address - Street 2:
Mailing Address - City:WEST LINN
Mailing Address - State:OR
Mailing Address - Zip Code:97068-3235
Mailing Address - Country:US
Mailing Address - Phone:503-656-0306
Mailing Address - Fax:
Practice Address - Street 1:5639 HOOD ST
Practice Address - Street 2:
Practice Address - City:WEST LINN
Practice Address - State:OR
Practice Address - Zip Code:97068-3235
Practice Address - Country:US
Practice Address - Phone:503-656-0306
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-30
Last Update Date:2012-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR0006575183500000X
WA12165183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist