Elisabeth Ruth Decelles, PMHNP
Nurse Practitioner, Psych/Mental Health in Salem, OR. Individual provider (NPI-1).
Details
- NPI
- 1114435807
- Entity type
- Individual (NPI-1)
- Name
- Elisabeth Ruth Decelles
- Credential
- PMHNP
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Jan 16, 2018
- Certification date
- Oct 9, 2020
- Last updated
- Nov 27, 2023
Medicare and OIG
- Medicare enrolled (PECOS)
- Yes · PRACTITIONER - NURSE PRACTITIONER
- Can order and refer
- Part B Yes · DME Yes · Home health Yes · Power mobility Yes · Hospice No
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363LP0808X | Nurse Practitioner, Psych/Mental Health | 201902988NP-PP | OR | Yes |
| 363LP0808X | Nurse Practitioner, Psych/Mental Health | AP10900 | AZ |
Practice location
1233 Edgewater St NwSalem, OR 97304-4049
Phone 503-378-7526
Mailing address
2550 E Show Low Lake Rd Bldg BShow Low, AZ 85901-7929
Phone 928-537-2951 · Fax 928-537-2071
Other practice locations
Show Low, AZ 85901-7929
Phone 928-537-2951 · Fax 928-537-2071
Is something wrong?
This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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All 128 Psychiatric/Mental Health Nurse Practitioner providers in Salem · All 8,143 providers in Salem
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