Provider Demographics
NPI:1275909079
Name:CAMPA, DANIEL M (EDS)
Entity Type:Individual
Prefix:MR
First Name:DANIEL
Middle Name:M
Last Name:CAMPA
Suffix:
Gender:M
Credentials:EDS
Other - Prefix:MR
Other - First Name:DANNY
Other - Middle Name:M
Other - Last Name:CAMPA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:EDS
Mailing Address - Street 1:33305 1ST WAY S
Mailing Address - Street 2:SUITE# B203
Mailing Address - City:FEDERAL WAY
Mailing Address - State:WA
Mailing Address - Zip Code:98003-6235
Mailing Address - Country:US
Mailing Address - Phone:253-235-5956
Mailing Address - Fax:253-235-5957
Practice Address - Street 1:33305 1ST WAY S
Practice Address - Street 2:SUITE# B203
Practice Address - City:FEDERAL WAY
Practice Address - State:WA
Practice Address - Zip Code:98003-6235
Practice Address - Country:US
Practice Address - Phone:253-235-5956
Practice Address - Fax:253-235-5957
Is Sole Proprietor?:No
Enumeration Date:2015-08-15
Last Update Date:2015-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program