Healthcare Provider Details

I. General information

NPI: 1841385507
Provider Name (Legal Business Name): ELIZABETH JOAN MILLER MSW,QMHP,CADC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/04/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

945 NE 165TH AVE
PORTLAND OR
97230-6148
US

IV. Provider business mailing address

3911 SE MALL ST APT 2D
PORTLAND OR
97202-9102
US

V. Phone/Fax

Practice location:
  • Phone: 503-408-8100
  • Fax: 503-408-8384
Mailing address:
  • Phone: 971-227-5783
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: