| Doctor Name: | IDA LOUISE CAMPBELL |
| NPI Number: | 1245347657 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | FNP |
| License Number: | 200650038NP |
| Business Practice Address: | 502 54th Ave E Fife, WA - 984242724 |
| Business Phone Number: | 2534597500 |
| Business Fax Number: | 2534597527 |
| Mailing Address: | 502 54th Ave E, FIFE |
| State: | WA |
| Postal Code: | 984242724 |
| Phone Number: | 2534597500 |
| Fax Number: | 2534597527 |
| NPI Enumeration Date: | 08/23/2006 |
| NPI Last Update Date: | 09/10/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | 200650038NP |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | OR |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |