Healthcare Provider Details

I. General information

NPI: 1053221606
Provider Name (Legal Business Name): CORI CAMPBELL
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/08/2026
Last Update Date: 09/08/2026
Certification Date: 09/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7320 SW HUNZIKER RD STE 204
TIGARD OR
97223-2301
US

IV. Provider business mailing address

17065 SW KINGLET DR
SHERWOOD OR
97140-8195
US

V. Phone/Fax

Practice location:
  • Phone: 503-837-3449
  • Fax: 503-536-6768
Mailing address:
  • Phone: 503-320-3530
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: