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NPI Code Detail

MEDICARE: MARCIE J MILLER LMP

MEDICARE:   MARCIE J MILLER  LMP
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
1225700000XMassage TherapistMA00021959WA

General Provider Information

NPI Number : 1700830320
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARCIE J MILLER LMP
Provider Business Mailing Address
First Line : PO BOX 731269
Second Line :
City : PUYALLUP
State : WA
Zip : 98373-0060
Country : US
Telephone Number : 253-840-2313
Fax Number : 253-840-6340
Provider Business Practice Location Address
First Line : 19820 STATE ROUTE 410 E
Second Line : SUITE 210
City : BONNEY LAKE
State : WA
Zip : 98391-6377
Country : US
Telephone Number : 253-863-7510
Fax Number : 253-863-5970
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/19/2006
Last Update Date : 07/08/2007

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Directions to “ MARCIE J MILLER LMP” Practice Location

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