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General NPI Number Information
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NPI Number | 1851377634
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Entity Type | Individual
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Provider Name | JOHN LESLIE MILLER M.D.
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Gender | Male
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Dates
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Enumeration Date | 12/22/2005
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Last Update Date | 03/07/2023
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Provider Practice Location Address
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Address Line | MADIGAN ARMY MEDICAL CENTER, ATTN:MCHJ-HOM 9040-A FITZSIMMONS AVE
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City | TACOMA
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State | WA
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Zip | 98431-0001
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Country | US
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Telephone | 253-968-3408
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Fax | 253-968-5572
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Provider Business Mailing Address
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Address Line | 12021 211TH PL SE
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City | SNOHOMISH
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State | WA
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Zip | 98296-3944
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Country | US
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Telephone | 360-668-3515
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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 | MD00014656
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License Number State | WA
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