Individual
DALLAS CAMPOCHIARO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1500 3RD AVE, LONGVIEW, WA 98632-3229
(360) 432-8800
Mailing address
119 WILLIAMS AVE, KELSO, WA 98626-4028
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OC61274926
WA
Other
Enumeration date
07/18/2023
Last updated
07/18/2023
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