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Organization

TISH CAMPBELL, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. LATISHA CAMPBELL PHD, CNS (FUNCTIONAL NUTRITIONIST)
(503) 260-4076
Entity
Organization

Contact information

Practice address
91-1245 FRANKLIN D ROOSEVELT AVE APT 319, KAPOLEI, HI 96707-2177
(503) 260-4076
Mailing address
91-1245 FRANKLIN D ROOSEVELT AVE APT 319, KAPOLEI, HI 96707-2177
(503) 260-4076

Taxonomy

Speciality
Code
Description
License number
State
133N00000X
Nutritionist
Primary

Other

Enumeration date
07/05/2024
Last updated
07/05/2024
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