Individual
ALAN CAMPBELL
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
280 MAPLE ST, ASHLAND, OR 97520-1552
(503) 482-2441
Mailing address
PO BOX 34935, DEPARTMENT 563, SEATTLE, WA 98124-1935
(888) 633-0079
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD18958
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0064852
—
OR
01
—
97520A004
CHAMPUS
—
01
—
F32127
PROVIDENCE HEALTH PLANS
—
01
—
XPY186019
MEDI-CAL
—
Enumeration date
04/12/2006
Last updated
07/08/2007
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