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General NPI Number Information
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NPI Number | 1912030149
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Entity Type | Organization
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Legal Business Name | M JAY CAMPBELL D C P S
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Dates
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Enumeration Date | 03/14/2007
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Last Update Date | 08/24/2022
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Provider Practice Location Address
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Address Line | 19125 33RD AVE W STE D
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City | LYNNWOOD
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State | WA
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Zip | 98036-4735
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Country | US
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Telephone | 425-776-8787
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Fax | 425-776-1349
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Provider Business Mailing Address
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Address Line | 19125 33RD AVE W STE D
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City | LYNNWOOD
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State | WA
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Zip | 98036-4735
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Country | US
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Telephone | 425-776-8787
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Fax | 425-776-1349
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Authorized Official
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Title or Position | PRESIDENT
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Name | MATTHEW JAY CAMPBELL
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Credential | DC
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Telephone | 425-776-8787
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | CH00002411
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License Number State | WA
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