Provider Demographics
NPI:1700357720
Name:CAMPANA, AMBER ELIZABETH (LAC)
Entity Type:Individual
Prefix:
First Name:AMBER
Middle Name:ELIZABETH
Last Name:CAMPANA
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:240 OAKWAY CTR
Mailing Address - Street 2:
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97401-5618
Mailing Address - Country:US
Mailing Address - Phone:541-735-3174
Mailing Address - Fax:541-219-5908
Practice Address - Street 1:240 OAKWAY CTR
Practice Address - Street 2:
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97401-5618
Practice Address - Country:US
Practice Address - Phone:541-735-3174
Practice Address - Fax:541-219-5908
Is Sole Proprietor?:Yes
Enumeration Date:2018-12-17
Last Update Date:2024-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR191400171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty