Healthcare Provider Details

I. General information

NPI: 1215894985
Provider Name (Legal Business Name): ALEXANDRA J CAMPBELL MSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/06/2026
Last Update Date: 08/12/2026
Certification Date: 08/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

88802 SUNNY LOOP LN
BANDON OR
97411-7396
US

IV. Provider business mailing address

630 MILUK DR
COOS BAY OR
97420-7728
US

V. Phone/Fax

Practice location:
  • Phone: 541-294-4998
  • Fax:
Mailing address:
  • Phone: 541-888-9494
  • Fax: 541-888-5556

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code374J00000X
TaxonomyDoula
License Number
License Number StateOR
# 2
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberA17467
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: