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NPI Code Detail

MEDICARE: LOGHAN GRACE MILLER

MEDICARE: LOGHAN GRACE MILLER
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1171M00000XCase Manager/Care CoordinatorOR

General Provider Information

NPI Number : 1205794716
Entity Type Code : Individual
Provider Name (Legal Business Name) : LOGHAN GRACE MILLER
Provider Business Mailing Address
First Line : 3729 KLINDT DR
Second Line :
City : THE DALLES
State : OR
Zip : 97058-3566
Country : US
Telephone Number : 541-298-2101
Fax Number : 541-298-7996
Provider Business Practice Location Address
First Line : 3729 KLINDT DR
Second Line :
City : THE DALLES
State : OR
Zip : 97058-3566
Country : US
Telephone Number : 541-298-2101
Fax Number : 541-298-7996
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/13/2026
Last Update Date : 01/13/2026

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Directions to “ LOGHAN GRACE MILLER ” Practice Location

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