Provider Demographics
NPI:1144071036
Name:CAMPBELL, ALYSSA (LSWAIC)
Entity type:Individual
Prefix:
First Name:ALYSSA
Middle Name:
Last Name:CAMPBELL
Suffix:
Gender:F
Credentials:LSWAIC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3710 168TH ST NE STE A207
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:WA
Mailing Address - Zip Code:98223-8464
Mailing Address - Country:US
Mailing Address - Phone:360-218-4645
Mailing Address - Fax:360-218-4645
Practice Address - Street 1:3710 168TH ST NE STE A207
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:WA
Practice Address - Zip Code:98223-8464
Practice Address - Country:US
Practice Address - Phone:360-218-4645
Practice Address - Fax:360-218-4645
Is Sole Proprietor?:No
Enumeration Date:2024-03-28
Last Update Date:2025-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WASC615356551041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical