MEDICARE: MS. MANDY MICHELE MILLER MFTI

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	106H00000X	Marriage & Family Therapist	46849	CA
2	106H00000X	Marriage & Family Therapist	T1614	OR

General Provider Information

NPI Number	:	1447331640
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. MANDY MICHELE MILLER MFTI

Provider Business Mailing Address
First Line	:	1716 SE LEXINGTON ST
Second Line	:
City	:	PORTLAND
State	:	OR
Zip	:	97202-6151
Country	:	US
Telephone Number	:	415-517-2380
Fax Number	:

Provider Business Practice Location Address
First Line	:	1500 NE IRVING ST STE 210
Second Line	:
City	:	PORTLAND
State	:	OR
Zip	:	97232-2243
Country	:	US
Telephone Number	:	154-517-2380
Fax Number	:

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

Provider Enumeration Date	:	10/17/2006
Last Update Date	:	05/30/2025

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