Provider Demographics
NPI:1730921438
Name:CAMPBELL, BREANNA (BSW)
Entity type:Individual
Prefix:
First Name:BREANNA
Middle Name:
Last Name:CAMPBELL
Suffix:
Gender:
Credentials:BSW
Other - Prefix:
Other - First Name:BREANNA
Other - Middle Name:
Other - Last Name:MULLINS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 839
Mailing Address - Street 2:
Mailing Address - City:EVERETT
Mailing Address - State:WA
Mailing Address - Zip Code:98206-0839
Mailing Address - Country:US
Mailing Address - Phone:425-259-3191
Mailing Address - Fax:
Practice Address - Street 1:1800 41ST ST STE 310
Practice Address - Street 2:
Practice Address - City:EVERETT
Practice Address - State:WA
Practice Address - Zip Code:98203-2355
Practice Address - Country:US
Practice Address - Phone:425-259-3191
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-06-12
Last Update Date:2025-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor