Individual
JOSIE CAMPBELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
506 S JACKSON ST, RITZVILLE, WA 99169-2106
(509) 659-1600
(509) 659-1317
Mailing address
506 S JACKSON ST, RITZVILLE, WA 99169-2106
(509) 659-1600
(509) 659-1317
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
603-462-445
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2044700
—
WA
01
—
47-2632481
TAX ID
WA
01
—
50-5282
MEDICARE PTAN
TN
Enumeration date
09/10/2015
Last updated
09/10/2015
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