Provider Demographics
NPI:1245223270
Name:CAMPBELL, BRIAN ROSS (PHD)
Entity Type:Individual
Prefix:DR
First Name:BRIAN
Middle Name:ROSS
Last Name:CAMPBELL
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:444 W 21ST AVE
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99203-1943
Mailing Address - Country:US
Mailing Address - Phone:509-624-3539
Mailing Address - Fax:509-624-3539
Practice Address - Street 1:105 W 8TH AVE
Practice Address - Street 2:SUITE 332
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99204-2302
Practice Address - Country:US
Practice Address - Phone:509-838-7400
Practice Address - Fax:509-283-8682
Is Sole Proprietor?:No
Enumeration Date:2005-08-24
Last Update Date:2007-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPY00001459103G00000X, 103TC0700X, 103TF0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103G00000XBehavioral Health & Social Service ProvidersClinical Neuropsychologist
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103TF0200XBehavioral Health & Social Service ProvidersPsychologistForensic