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General NPI Number Information
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NPI Number | 1902291115
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Entity Type | Organization
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Legal Business Name | COURTNEY MILLER PLLC
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Dates
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Enumeration Date | 04/03/2015
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Last Update Date | 06/01/2016
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Provider Practice Location Address
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Address Line | 5803 232ND ST SW
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City | MOUNTLAKE TERRACE
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State | WA
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Zip | 98043-4637
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Country | US
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Telephone | 425-835-2831
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Fax |
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Provider Business Mailing Address
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Address Line | 5803 232ND ST SW
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City | MOUNTLAKE TERRACE
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State | WA
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Zip | 98043-4637
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Country | US
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Telephone | 425-835-2831
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | COURTNEY MILLER
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Credential | MSW, LICSW
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Telephone | 425-835-2831
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | LW6049049
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License Number State | WA
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