Provider Demographics
NPI:1275909079
Name:CAMPA, DANIEL M (PHD, EDS)
Entity type:Individual
Prefix:MR
First Name:DANIEL
Middle Name:M
Last Name:CAMPA
Suffix:
Gender:M
Credentials:PHD, EDS
Other - Prefix:MR
Other - First Name:DANNY
Other - Middle Name:M
Other - Last Name:CAMPA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PHD, EDS
Mailing Address - Street 1:33930 WEYERHAEUSER WAY S STE 220
Mailing Address - Street 2:
Mailing Address - City:FEDERAL WAY
Mailing Address - State:WA
Mailing Address - Zip Code:98001-9783
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:33930 WEYERHAEUSER WAY S STE 220
Practice Address - Street 2:
Practice Address - City:FEDERAL WAY
Practice Address - State:WA
Practice Address - Zip Code:98001-9783
Practice Address - Country:US
Practice Address - Phone:253-752-7320
Practice Address - Fax:253-276-6624
Is Sole Proprietor?:No
Enumeration Date:2015-08-15
Last Update Date:2025-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPY61041249103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist