Healthcare Provider Details

I. General information

NPI: 1871178657
Provider Name (Legal Business Name): SAHARA MILLER COUNSELING LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/13/2021
Last Update Date: 09/07/2021
Certification Date: 09/07/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5305 RIVER RD NORTH STE B
KEIZER OR
97303
US

IV. Provider business mailing address

PO BOX 18133
PORTLAND OR
97218
US

V. Phone/Fax

Practice location:
  • Phone: 503-405-8088
  • Fax:
Mailing address:
  • Phone: 503-405-8088
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: SAHARA BETH MILLER
Title or Position: OWNER
Credential: LPC
Phone: 503-405-8088