Healthcare Provider Details

I. General information

NPI: 1396324075
Provider Name (Legal Business Name): DAVID L CAMPBELL DSW, MA, LMFT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/07/2021
Last Update Date: 12/25/2025
Certification Date: 12/25/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

61667 SOMERSET DR
BEND OR
97702-8704
US

IV. Provider business mailing address

20013 VOLTERA PL
BEND OR
97702-3013
US

V. Phone/Fax

Practice location:
  • Phone: 541-241-3430
  • Fax:
Mailing address:
  • Phone: 619-228-4523
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number113829
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberT2445
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: