Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208200000X | Surgeon | MD00045866 | WA |
Y | 208600000X | Surgeon | MD00045866 | WA |
NPI | 1023051919 |
---|---|
Provider Name | James P Miller |
First Address | Portland, OR 97208-3360 |
Second Address | Everett, WA 98201 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/06/2006 |
Last Update Date | 01/03/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1038677 | (05) | WA |