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General NPI Number Information
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NPI Number | 1093830879
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Entity Type | Individual
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Provider Name | STEPHEN JONATHON MILLER RPH
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Gender | Male
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Dates
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Enumeration Date | 03/20/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 5721 NE 138TH AVE
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City | PORTLAND
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State | OR
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Zip | 97230-3409
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Country | US
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Telephone | 503-261-7501
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Fax | 503-261-7520
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Provider Business Mailing Address
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Address Line | 2762 VALE CT
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City | LAKE OSWEGO
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State | OR
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Zip | 97034-7536
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Country | US
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Telephone | 503-638-1192
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 6580
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License Number State | OR
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