Healthcare Provider Details

I. General information

NPI: 1639853922
Provider Name (Legal Business Name): HANNAH MILLER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/15/2023
Last Update Date: 08/06/2025
Certification Date: 08/06/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3020 S UNION AVE
TACOMA WA
98409-3317
US

IV. Provider business mailing address

917 PACIFIC AVE STE 600
TACOMA WA
98402-4437
US

V. Phone/Fax

Practice location:
  • Phone: 253-844-4327
  • Fax:
Mailing address:
  • Phone: 253-844-4327
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: