MEDICARE: DR. MARY EULALIA MILLER MD

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	208000000X	Pediatrics Physician	MD28552	OR

General Provider Information

NPI Number	:	1538208525
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MARY EULALIA MILLER MD

Provider Business Mailing Address
First Line	:	2051 KAEN RD STE 367
Second Line	:
City	:	OREGON CITY
State	:	OR
Zip	:	97045-4035
Country	:	US
Telephone Number	:	503-742-5300
Fax Number	:	503-742-5359

Provider Business Practice Location Address
First Line	:	501 N GRAHAM ST STE 250
Second Line	:
City	:	PORTLAND
State	:	OR
Zip	:	97227-1651
Country	:	US
Telephone Number	:	503-413-2902
Fax Number	:

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

Provider Enumeration Date	:	02/06/2007
Last Update Date	:	05/06/2026

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