Provider Demographics
NPI:1972889327
Name:CAMBER, DOMINICK PETER (LICSW)
Entity type:Individual
Prefix:MR
First Name:DOMINICK
Middle Name:PETER
Last Name:CAMBER
Suffix:
Gender:M
Credentials:LICSW
Other - Prefix:MR
Other - First Name:DOMINICK
Other - Middle Name:PETER
Other - Last Name:CAMPBELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:8401 5TH AVE NE
Mailing Address - Street 2:SUITE 103
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98115-4180
Mailing Address - Country:US
Mailing Address - Phone:206-659-6004
Mailing Address - Fax:
Practice Address - Street 1:8401 5TH AVE NE
Practice Address - Street 2:SUITE 103
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98115-4180
Practice Address - Country:US
Practice Address - Phone:206-659-6004
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-31
Last Update Date:2015-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALW605216071041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical