ELISABETH RUTH DECELLES (NPI# 1114435807) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1114435807 |
| Entity Type | Individual |
| Full Name | ELISABETH RUTH DECELLES |
| Credential | PMHNP |
| Practice Address |
1233 Edgewater St Nw Salem OR 97304-4049 |
| Mailing Address |
2550 E Show Low Lake Rd Bldg B Show Low AZ 85901-7929 |
| Practice Telephone | 5033787526 |
| Mailing Telephone | 9285372951 |
| Mailing Fax Number | 9285372071 |
| Enumeration Date | 2018-01-16 |
| Last Update Date | 2020-10-09 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LP0808X |
Nurse Practitioner Specialization: Psych/Mental Health |
201902988NP-PP | OR | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363LP0808X |
Nurse Practitioner Specialization: Psych/Mental Health |
AP10900 | AZ | Physician Assistants & Advanced Practice Nursing Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 2550 E Show Low Lake Rd Bldg B, Show Low, AZ 859017929 | 9285372951 | 9285372071 |
| Street Address |
1233 EDGEWATER ST NW |
| City | SALEM |
| State | OR |
| Zip Code | 97304-4049 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306827100 | William Earle Williams | Physician Assistant | 1233 Edgewater St Nw, Salem, OR 97304-4049 | 2005-11-08 |
| 1336758630 | Ted Alas | Community Health Worker | 1233 Edgewater St Nw, Salem, OR 97304-4049 | 2020-07-23 |
| 1245849462 | Taylor Thompson | Community Health Worker | 1233 Edgewater St Nw, Salem, OR 97304-4049 | 2020-07-23 |
| 1063021285 | Stephanie Ochoa | Community Health Worker | 1233 Edgewater St Nw, Salem, OR 97304-4049 | 2020-07-23 |
| 1376152603 | Kathryn Nicole Kelley | Community Health Worker | 1233 Edgewater St Nw, Salem, OR 97304-4049 | 2020-07-22 |
| 1386280352 | Terry Denise Banta | Social Worker | 1233 Edgewater St Nw, Salem, OR 97304-4049 | 2019-11-25 |
| 1407498074 | Jacob Benjamin Johnston | Technician | 1233 Edgewater St Nw, Salem, OR 97304-4049 | 2019-10-15 |
| 1346723038 | Erik Stephen Gillis | Physician Assistant | 1233 Edgewater St Nw, Salem, OR 97304-4049 | 2018-09-10 |
| 1215414669 | Taylor Jeanne Mcdowell | Physician Assistant | 1233 Edgewater St Nw, Salem, OR 97304-4049 | 2018-07-27 |
| 1780196220 | Deborah Gloria Baca-dietz | Nurse Practitioner | 1233 Edgewater St Nw, Salem, OR 97304 | 2017-10-24 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114413010 | Sam Mackenzie Lane | Massage Therapist | 1661 Edgewater St Nw # 120, Salem, Or 97304, Salem, OR 97304 | 2018-07-03 |
| 1144761131 | Rachel E Carson | Physical Therapist | 1025 2nd St. Nw, West Salem, OR 97304 | 2017-03-10 |
| 1962951061 | Lee Ann Nail | Social Worker | 3965 Gibson Rd Nw, Salem, OR 97304 | 2016-09-29 |
| 1619421591 | Logan Walters | Physical Therapist | 1025 2nd St Nw, Salem, OR 97304 | 2016-08-09 |
| 1770941338 | Tysandra Gillis | Massage Therapist | 859 Mule Deer St., Salem, OR 97304 | 2016-02-10 |
| 1144620295 | Molly Rodden | Nurse Practitioner | 1174 Cornucopia St Nw Ste 240, Salem, OR 97304 | 2014-08-26 |
| 1881942126 | Cynthia Ruth Rettler | Registered Nurse | 1520 Plaza St Nw Ste 150, Salem, OR 97304 | 2012-08-16 |
| 1336401017 | Trillium Family Services | Community/Behavioral Health | 1520 Plaza Street Nw, Suite 100, Salem, OR 97304 | 2012-06-08 |
| 1033428198 | Kathleen Ketelson | Nurse Practitioner | 560 Wallace Rd Nw Ste 140, Salem, OR 97304 | 2010-10-06 |
| 1922332535 | Robert Scott Mcadam | Social Worker | 1245 Edgewater St. Nw, Salem, OR 97304 | 2009-09-29 |
| Find all providers in zip 97304 | ||||
| Taxonomy Code | 363LP0808X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Psych/Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366073421 | Aspire Telepsychiatry | Nurse Practitioner | 1910 24th St Ne, Salem, OR 97301-8150 | 2020-01-28 |
| 1962058362 | Kimberly Diane Nelson | Nurse Practitioner | 35 Congress St Ste 225, Salem, MA 01970-5529 | 2019-08-13 |
| 1861970972 | Norrine Mcnelley | Nurse Practitioner | 25 Beechwood Rd, Salem, NH 03079 | 2018-07-31 |
| 1235493495 | Sarah Frances Robbins | Nurse Practitioner | 1595 Roosevelt St Ne, Salem, OR 97301 | 2012-07-02 |
| 1700155538 | Vanessa Anne Underwood | Nurse Practitioner | 1595 Cottage St Ne, Salem, OR 97301-7123 | 2011-12-22 |
| 1134364524 | Sharon Vaden Karn | Nurse Practitioner | 870 Commercial St Se, Salem, OR 97302-4108 | 2008-12-12 |
| 1861605768 | Barbara S Miller | Nurse Practitioner | Odoc, 2605 State St, Salem, OR 97310-0001 | 2007-05-07 |
| 1538225818 | Aleyna Cecile Reed | Nurse Practitioner | 685 Cottage St Ne, Salem, OR 97301-2419 | 2006-12-29 |
| 1407915408 | James Ben Newman | Nurse Practitioner | 1235 Woodrow St Ne, Salem, OR 97303-3214 | 2006-12-06 |
| 1033285713 | Rita Herlong | Nurse Practitioner | 4035 12th Street Cutoff, Suit120, Salem, OR 97302-1764 | 2006-11-27 |
| Find all providers in SALEM | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.