MEDICARE: CAITLYN MILLER LPN

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	164W00000X	Licensed Practical Nurse	LP70027108	WA

General Provider Information

NPI Number	:	1528924412
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CAITLYN MILLER LPN

Provider Business Mailing Address
First Line	:	1904 LARSON WAY
Second Line	:
City	:	VANCOUVER
State	:	WA
Zip	:	98661-5714
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1601 E 4TH PLAIN BLVD
Second Line	:
City	:	VANCOUVER
State	:	WA
Zip	:	98661-3713
Country	:	US
Telephone Number	:	360-696-4061
Fax Number	:

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

Provider Enumeration Date	:	01/05/2026
Last Update Date	:	01/05/2026

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