Provider Demographics
NPI:1043491038
Name:MILLER, SETH BRUCE (MS)
Entity Type:Individual
Prefix:MR
First Name:SETH
Middle Name:BRUCE
Last Name:MILLER
Suffix:
Gender:M
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11014 39TH AVE NE
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98125-5714
Mailing Address - Country:US
Mailing Address - Phone:206-363-6487
Mailing Address - Fax:
Practice Address - Street 1:11014 39TH AVE NE
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98125-5714
Practice Address - Country:US
Practice Address - Phone:206-363-6487
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-11-18
Last Update Date:2007-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALL00004512235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WALL00004512OtherWASHINGTON STATE LICENSE