Active NPI
Bruin Campbell
- Professional Counselor
- Tigard, OR
National Provider Identifier
1841874294
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- Practice address
- 9370 SW Greenburg Rd Ste 413
Tigard, OR 97223-5427 - Phone
- (971) 302-7374
- NPI assigned
- May 11, 2021
- Reactivated
- Dec 15, 2022
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | Primary |
Addresses
Primary practice location
9370 SW Greenburg Rd Ste 413
Tigard, OR 97223-5427
Mailing address
12954 SW Tearose Way
Portland, OR 97223-6686
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1620691200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1788652800000",
"number": "1841874294",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12954 SW TEAROSE WAY",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972236686"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9370 SW GREENBURG RD STE 413",
"city": "TIGARD",
"state": "OR",
"postal_code": "972235427",
"telephone_number": "971-302-7374"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CAMPBELL",
"first_name": "BRUIN",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2021-05-11",
"last_updated": "2026-09-06",
"certification_date": "2022-12-15",
"deactivation_date": "2022-10-25",
"reactivation_date": "2022-12-15",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Tigard, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.