Provider Demographics
NPI:1689924508
Name:DECKER, TIFFANY D (CD(DONA))
Entity Type:Individual
Prefix:
First Name:TIFFANY
Middle Name:D
Last Name:DECKER
Suffix:
Gender:F
Credentials:CD(DONA)
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1266 NE 56TH CT
Mailing Address - Street 2:
Mailing Address - City:HILLSBORO
Mailing Address - State:OR
Mailing Address - Zip Code:97124-6151
Mailing Address - Country:US
Mailing Address - Phone:805-895-9589
Mailing Address - Fax:
Practice Address - Street 1:1266 NE 56TH CT
Practice Address - Street 2:
Practice Address - City:HILLSBORO
Practice Address - State:OR
Practice Address - Zip Code:97124-6151
Practice Address - Country:US
Practice Address - Phone:805-895-9589
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-09-18
Last Update Date:2012-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula