MEDICARE: LINDA LOUISE MILLER D.O.

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	2084P0800X	Psychiatry Physician	OP00001560	WA

General Provider Information

NPI Number	:	1306914346
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LINDA LOUISE MILLER D.O.

Provider Business Mailing Address
First Line	:	PO BOX 1329
Second Line	:
City	:	BLOOMINGTON
State	:	IN
Zip	:	47402-1329
Country	:	US
Telephone Number	:	812-353-9816
Fax Number	:	812-353-5228

Provider Business Practice Location Address
First Line	:	3000 LIMITED LN NW STE 135
Second Line	:
City	:	OLYMPIA
State	:	WA
Zip	:	98502-2704
Country	:	US
Telephone Number	:	360-701-1715
Fax Number	:	360-943-0118

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/30/2006
Last Update Date	:	11/08/2019

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