Healthcare Provider Details

I. General information

NPI: 1912537374
Provider Name (Legal Business Name): NATALIE MARIE MILLER PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: NATALIE MARIE CASSON PA-C

II. Dates (important events)

Enumeration Date: 01/23/2020
Last Update Date: 02/20/2025
Certification Date: 02/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

US NAVAL HOSPITAL OKINAWA
CHATAN NAKAGAMI DISTRICT
9040103
JP

IV. Provider business mailing address

3329 BAYLOR CT SE
LACEY WA
98503-6224
US

V. Phone/Fax

Practice location:
  • Phone: 98-971-9355
  • Fax:
Mailing address:
  • Phone: 928-279-2560
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: