Provider Demographics
NPI:1568904092
Name:CAMPBELL, JESSICA (MS)
Entity Type:Individual
Prefix:MRS
First Name:JESSICA
Middle Name:
Last Name:CAMPBELL
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:422 W RIVERSIDE AVE STE 518
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99201-0302
Mailing Address - Country:US
Mailing Address - Phone:509-289-5908
Mailing Address - Fax:
Practice Address - Street 1:422 W RIVERSIDE AVE STE 518
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99201-0302
Practice Address - Country:US
Practice Address - Phone:509-289-5908
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-11-15
Last Update Date:2022-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health