Healthcare Provider Details

I. General information

NPI: 1053811448
Provider Name (Legal Business Name): MS. CHELSEA JANE MILLER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/13/2018
Last Update Date: 08/05/2026
Certification Date: 08/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1033 SW 152ND ST
BURIEN WA
98166-1845
US

IV. Provider business mailing address

9537 48TH AVE NE
SEATTLE WA
98115-2623
US

V. Phone/Fax

Practice location:
  • Phone: 206-242-1698
  • Fax:
Mailing address:
  • Phone: 661-753-4791
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: