Provider Demographics
NPI:1942771365
Name:MCCOMB CAMPBELL, TAYLOR ELISE (CBD)
Entity Type:Individual
Prefix:
First Name:TAYLOR
Middle Name:ELISE
Last Name:MCCOMB CAMPBELL
Suffix:
Gender:F
Credentials:CBD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:828 RESER RD
Mailing Address - Street 2:
Mailing Address - City:WALLA WALLA
Mailing Address - State:WA
Mailing Address - Zip Code:99362-8718
Mailing Address - Country:US
Mailing Address - Phone:805-280-9734
Mailing Address - Fax:
Practice Address - Street 1:828 RESER RD
Practice Address - Street 2:
Practice Address - City:WALLA WALLA
Practice Address - State:WA
Practice Address - Zip Code:99362-8718
Practice Address - Country:US
Practice Address - Phone:805-280-9734
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-12-11
Last Update Date:2019-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula