Provider Demographics
NPI:1053454397
Name:MILLER, ANDREA M (LAC)
Entity Type:Individual
Prefix:MS
First Name:ANDREA
Middle Name:M
Last Name:MILLER
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3601 FREMONT AVE N STE 412
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98103-8753
Mailing Address - Country:US
Mailing Address - Phone:206-860-1704
Mailing Address - Fax:206-545-9330
Practice Address - Street 1:3601 FREMONT AVE N STE 412
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98103-8753
Practice Address - Country:US
Practice Address - Phone:206-860-1704
Practice Address - Fax:206-545-9330
Is Sole Proprietor?:No
Enumeration Date:2007-02-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAC00000474171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist