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General NPI Number Information
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NPI Number | 1447331640
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Entity Type | Individual
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Provider Name | MANDY MICHELE MILLER MFTI
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Gender | Female
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Dates
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Enumeration Date | 10/17/2006
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Last Update Date | 05/30/2025
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Provider Practice Location Address
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Address Line | 1500 NE IRVING ST STE 210
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City | PORTLAND
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State | OR
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Zip | 97232-2243
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Country | US
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Telephone | 154-517-2380
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Fax |
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Provider Business Mailing Address
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Address Line | 1716 SE LEXINGTON ST
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City | PORTLAND
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State | OR
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Zip | 97202-6151
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Country | US
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Telephone | 415-517-2380
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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 | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 46849
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | T1614
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License Number State | OR
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