Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207N00000X | Dermatologist | MD60173899 | WA |
N | 207ND0101X | MOHS-Micrographic Surgeon | MD60173899 | WA |
N | 207ND0900X | Dermatopathologist | MD60173899 | WA |
N | 207NS0135X | Procedural Dermatology | MD60173899 | WA |
NPI | 1407990161 |
---|---|
Provider Name | Arlo J Miller |
First Address | Issaquah, WA 98027-2483 |
Second Address | Issaquah, WA 98027-2483 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 16/02/2007 |
Last Update Date | 15/12/2021 |