Healthcare Provider Details

I. General information

NPI: 1598672990
Provider Name (Legal Business Name): CYNTHIA DIANNE MILLER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/24/2026
Last Update Date: 08/24/2026
Certification Date: 08/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

833 WILLIAMSON LOOP
GRANTS PASS OR
97526-8717
US

IV. Provider business mailing address

833 WILLIAMSON LOOP
GRANTS PASS OR
97526-8717
US

V. Phone/Fax

Practice location:
  • Phone: 408-466-4594
  • Fax:
Mailing address:
  • Phone: 408-466-4594
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174H00000X
TaxonomyHealth Educator
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: