MEDICARE: MS. LINDA GAY 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
1	225700000X	Massage Therapist	MA00022084	WA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	0208392	OTHER	WA	DEPT LABOR OF INDUSTRIES
2	MA00022084	OTHER	WA	STATE MASSAGE LISCENSE

General Provider Information

NPI Number	:	1912073545
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. LINDA GAY MILLER LMP

Provider Business Mailing Address
First Line	:	4808 GAY RD E
Second Line	:
City	:	TACOMA
State	:	WA
Zip	:	98443
Country	:	US
Telephone Number	:	253-926-8930
Fax Number	:

Provider Business Practice Location Address
First Line	:	KRONLUND CHIROPRACTIC CLINIC PS
Second Line	:	3820 SO 320TH
City	:	AUBURN
State	:	WA
Zip	:	98001
Country	:	US
Telephone Number	:	253-839-2650
Fax Number	:	253-839-4528

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

Provider Enumeration Date	:	11/27/2006
Last Update Date	:	07/08/2007

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