Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 204D00000X | Neuromusculoskeletal Medicine (NMM) | 14341 | OR |
NPI | 1033323936 |
---|---|
Provider Name | Dr. Paul Stanley Miller |
First Address | Lake Oswego, OR 97035-2503 |
Second Address | Lake Oswego, OR 97035-2503 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 09/05/2007 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
E 38895 | (02) | OR |