Healthcare Provider Details

I. General information

NPI: 1669735304
Provider Name (Legal Business Name): JOHN S MILLER, DC, DACBR, PS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/18/2012
Last Update Date: 06/18/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9015 HOLMAN RD NW SUITE 3
SEATTLE WA
98117-3481
US

IV. Provider business mailing address

9015 HOLMAN RD NW SUITE 3
SEATTLE WA
98117-3481
US

V. Phone/Fax

Practice location:
  • Phone: 206-784-8119
  • Fax: 206-784-4020
Mailing address:
  • Phone: 206-784-8119
  • Fax: 206-784-4020

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111NR0200X
TaxonomyRadiology Chiropractor
License NumberCH00002256
License Number StateWA

VIII. Authorized Official

Name: DR. JOHN S MILLER
Title or Position: PRESIDENT
Credential: DC
Phone: 206-784-8119