Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207PP0204X | Pediatric Emergency Physician | MD60518702 | WA |
N | 208000000X | Pediatrician | MD60518702 | WA |
N | 2080P0204X | Pediatric Emergency Doctor | 18189 | OR |
N | 2080P0204X | Pediatric Emergency Doctor | 55716 | MN |
Y | 2080P0204X | Pediatric Emergency Doctor | MD60518702 | WA |
NPI | 1437155298 |
---|---|
Provider Name | Helen Carney Miller |
First Address | Portland, OR 97239-1405 |
Second Address | Buckley, WA 98321-7505 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/06/2005 |
Last Update Date | 25/04/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
060579 | (05) | OR |