# JOSIE CAMPBELL

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** Yes

## Provider details

- **NPI number:** 1033587845
- **Gender:** F
- **Credential:** D.O.

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 314000000X | Skilled Nursing Facility | 603-462-445 | WA | Yes |

## Other

- **Enumeration date:** 09/10/2015
- **Last updated:** 09/10/2015

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 2044700 | — | WA |
| 01 | — | 47-2632481 | TAX ID | WA |
| 01 | — | 50-5282 | MEDICARE PTAN | TN |