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General NPI Number Information
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NPI Number | 1013969856
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Entity Type | Individual
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Provider Name | PETER CAMPBELL GREGORY MD
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Gender | Male
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Dates
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Enumeration Date | 05/17/2006
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Last Update Date | 04/20/2020
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Provider Practice Location Address
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Address Line | 32014 32ND AVE S
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City | FEDERAL WAY
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State | WA
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Zip | 98001-9625
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Country | US
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Telephone | 253-874-7107
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Fax | 253-874-1923
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Provider Business Mailing Address
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Address Line | 32014 32ND AVE S SOUND VASCULAR & VEIN
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City | FEDERAL WAY
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State | WA
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Zip | 98001
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Country | US
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Telephone | 253-874-7107
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RN0300X
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Taxonomy Name | Nephrology Physician
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License Number | MD00045907
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License Number State | WA
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