Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103G00000X | Clinical Psychologist | 1232 | OR |
Y | 103TC0700X | Clinical Psychologist | 1232 | OR |
NPI | 1013130863 |
---|---|
Provider Name | Dr. Linda Wood Miller |
First Address | Portland, OR 97205-2125 |
Second Address | Portland, OR 97205-2125 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 10/04/2007 |
Last Update Date | 08/07/2007 |