Healthcare Provider Details

I. General information

NPI: 1861720195
Provider Name (Legal Business Name): ELIZABETH LEANNA CAMPBELL PH.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ELIZABETH LEANNA CAMPBELL L.P.

II. Dates (important events)

Enumeration Date: 11/24/2009
Last Update Date: 08/27/2024
Certification Date: 08/25/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3101 EAST BOONE AVENUE
SPOKANE WA
99202
US

IV. Provider business mailing address

7512 E 7TH LN
SPOKANE VALLEY WA
99212-7002
US

V. Phone/Fax

Practice location:
  • Phone: 509-934-0178
  • Fax:
Mailing address:
  • Phone: 509-777-4952
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberLF60917491
License Number StateWA
# 2
Primary TaxonomyY
Taxonomy Code103TC1900X
TaxonomyCounseling Psychologist
License NumberPY60304131
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: