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General NPI Number Information
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NPI Number | 1396739967
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Entity Type | Individual
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Provider Name | DARRELL M. MILLER M.D.
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Gender | Male
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Dates
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Enumeration Date | 09/09/2005
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Last Update Date | 08/06/2009
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Provider Practice Location Address
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Address Line | 406 SE 131ST AVE SUITE 101
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City | VANCOUVER
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State | WA
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Zip | 98683-4004
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Country | US
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Telephone | 360-253-2822
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Fax | 360-253-8642
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Provider Business Mailing Address
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Address Line | 4421 NE ST JOHNS RD
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City | VANCOUVER
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State | WA
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Zip | 98661-2573
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Country | US
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Telephone | 360-695-9922
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Fax | 360-695-1310
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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 | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | 15075
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License Number State | WA
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Taxonomy #2
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | 15075
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License Number State | WA
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