Provider Demographics
NPI:1215251665
Name:CAMPBELL, ERIC JOEL (ABOC, DO)
Entity type:Individual
Prefix:
First Name:ERIC
Middle Name:JOEL
Last Name:CAMPBELL
Suffix:
Gender:M
Credentials:ABOC, DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19510 NE 8TH ST
Mailing Address - Street 2:
Mailing Address - City:CAMAS
Mailing Address - State:WA
Mailing Address - Zip Code:98607-9252
Mailing Address - Country:US
Mailing Address - Phone:503-891-1612
Mailing Address - Fax:
Practice Address - Street 1:19510 NE 8TH ST
Practice Address - Street 2:
Practice Address - City:CAMAS
Practice Address - State:WA
Practice Address - Zip Code:98607-9252
Practice Address - Country:US
Practice Address - Phone:503-891-1612
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-15
Last Update Date:2010-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOptician