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General NPI Number Information
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NPI Number | 1548735707
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Entity Type | Individual
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Provider Name | VICTOR PALACIOS CAMPOS
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Gender | Male
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Dates
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Enumeration Date | 10/03/2018
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Last Update Date | 08/16/2025
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Provider Practice Location Address
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Address Line | 31500 1ST AVE S APT 11-303
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City | FEDERAL WAY
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State | WA
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Zip | 98003-4631
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Country | US
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Telephone | 206-200-3119
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Fax |
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Provider Business Mailing Address
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Address Line | 31500 1ST AVE S APT 11-303
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City | FEDERAL WAY
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State | WA
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Zip | 98003-4631
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Country | US
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Telephone | 206-200-3119
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | MC60894074
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License Number State | WA
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | LH61071652
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License Number State | WA
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