Provider Demographics
NPI:1487179651
Name:CAMPBELL, DEBRA LEE (PHARMD)
Entity Type:Individual
Prefix:
First Name:DEBRA
Middle Name:LEE
Last Name:CAMPBELL
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4258 OVERLOOK CT
Mailing Address - Street 2:
Mailing Address - City:GIG HARBOR
Mailing Address - State:WA
Mailing Address - Zip Code:98332-7915
Mailing Address - Country:US
Mailing Address - Phone:727-543-6110
Mailing Address - Fax:
Practice Address - Street 1:3320 S 23RD ST
Practice Address - Street 2:
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98405-1603
Practice Address - Country:US
Practice Address - Phone:253-414-0303
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-08-09
Last Update Date:2017-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPH60702370183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist