MEDICARE: DAVID SHEN-MILLER, PLLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QM0855X	Adolescent and Children Mental Health Clinic/Center
2	261QM0850X	Adult Mental Health Clinic/Center

General Provider Information

NPI Number	:	1144867672
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DAVID SHEN-MILLER, PLLC

Provider Business Mailing Address
First Line	:	1914 N 34TH ST STE 206
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98103-9089
Country	:	US
Telephone Number	:	541-954-3755
Fax Number	:

Provider Business Practice Location Address
First Line	:	1914 N 34TH ST STE 206
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98103-9089
Country	:	US
Telephone Number	:	541-954-3755
Fax Number	:

Authorized Official
Title or Position	:	PSYCHOLOGIST/OWNER
Name	:	DR. DAVID SHEN-MILLER
Credential	:	PH.D.
Telephone Number	:	541-954-3755

Provider Enumeration Date	:	12/03/2019
Last Update Date	:	12/03/2019

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