Active NPI
Jeanette Germaine Decoteau, PAC
- Medical Physician Assistant
- Auburn, WA
National Provider Identifier
1528189750
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Medical Physician Assistant
- License
- PA10001216
- Practice address
- 17500 SE 392ND St
Auburn, WA 98092-9705 - Phone
- (253) 939-6648
- Fax
- (253) 887-8737
- NPI assigned
- Apr 3, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Medical Physician Assistant | 363AM0700X | PA10001216 | WA | Primary |
Addresses
Primary practice location
17500 SE 392ND St
Auburn, WA 98092-9705
Mailing address
17500 SE 392ND St
Auburn, WA 98092-9705
Phone (253) 939-6648
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PA10001216 | WA | MD | Medical Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1175558400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1528189750",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "17500 SE 392ND ST",
"city": "AUBURN",
"state": "WA",
"postal_code": "980929705",
"telephone_number": "253-939-6648",
"fax_number": "253-887-8737"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "17500 SE 392ND ST",
"city": "AUBURN",
"state": "WA",
"postal_code": "980929705",
"telephone_number": "253-939-6648",
"fax_number": "253-887-8737"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DECOTEAU",
"first_name": "JEANETTE",
"middle_name": "GERMAINE",
"credential": "PAC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-04-03",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "363AM0700X",
"taxonomy_group": "",
"desc": "Physician Assistant, Medical",
"state": "WA",
"license": "PA10001216",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Auburn, WA
- De la Cruz Optical LLC (De La Cruz Optical)
- Hieu N De la Rosa, DOCTOR OF PHARMACY
- Nicolas De la Torre, M.S., CCC-SLP
- Jennifer Dean
- Nolan Deatherage, DC
- Stephanie Decremer, ATC
- Judi M Dedge, LMP
- William G. Dedge, DC
- Defazio Grewell Acupuncture, Inc. (Auburn Acupuncture Clinic)
- Molly Ann Defazio, L.AC.
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.