Individual
ANNIKA MICHELE JOHNSON CAMPBELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PSYD
Contact information
Practice address
1175 MOUNT HOOD AVE, WOODBURN, OR 97071-9060
(509) 662-6000
Mailing address
1175 MOUNT HOOD AVE, WOODBURN, OR 97071-9060
(503) 982-2000
(503) 982-0660
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
MC60969986
WA
101YM0800X
Mental Health Counselor
MC60969986
WA
103T00000X
Psychologist
Primary
3425
OR
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2133958
—
WA
Enumeration date
04/10/2019
Last updated
05/09/2022
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