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General NPI Number Information
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NPI Number | 1497727903
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Entity Type | Individual
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Provider Name | GREGORY MILLER MD
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Gender | Male
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Dates
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Enumeration Date | 02/07/2006
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Last Update Date | 12/22/2016
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Provider Practice Location Address
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Address Line | 1225 NE 2ND AVE
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City | PORTLAND
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State | OR
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Zip | 97232-2003
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Country | US
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Telephone | 503-944-8010
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Fax |
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Provider Business Mailing Address
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Address Line | 3181 SW SAM JACKSON PARK RD
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City | PORTLAND
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State | OR
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Zip | 97239-3011
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Country | US
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Telephone |
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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 | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 042.0011077
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License Number State | VT
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Taxonomy #2
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 223300
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License Number State | MA
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Taxonomy #3
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | MD177057
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License Number State | OR
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