MEDICARE: MS. MARY MARGARET MILES M.A.

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
1	101YP2500X	Professional Counselor

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	0000WDBCH	OTHER	OR	GROUP MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1306088414
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. MARY MARGARET MILES M.A.

Provider Business Mailing Address
First Line	:	12248 SE MOUNTAIN SUN DR
Second Line	:
City	:	CLACKAMAS
State	:	OR
Zip	:	97015-6214
Country	:	US
Telephone Number	:	503-698-3537
Fax Number	:

Provider Business Practice Location Address
First Line	:	880 82ND DR
Second Line	:	GLADSTONE
City	:	GLADSTONE
State	:	OR
Zip	:	97027-1803
Country	:	US
Telephone Number	:	503-659-5515
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/03/2009
Last Update Date	:	12/03/2025

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