Healthcare Provider Details

I. General information

NPI: 1043247174
Provider Name (Legal Business Name): SUZANNE BEVERLEE MILLAR PHARM.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/26/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1601 E 4TH PLAIN BLVD
VANCOUVER WA
98661-3753
US

IV. Provider business mailing address

21221 S TAHYEE RD
OREGON CITY OR
97045-9151
US

V. Phone/Fax

Practice location:
  • Phone: 503-220-8262
  • Fax:
Mailing address:
  • Phone: 503-632-6413
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P1200X
TaxonomyPharmacotherapy Pharmacist
License Number6735
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: