Provider Demographics
NPI:1063635969
Name:MILLER-READ, KATHLEEN (LMP)
Entity Type:Individual
Prefix:MS
First Name:KATHLEEN
Middle Name:
Last Name:MILLER-READ
Suffix:
Gender:F
Credentials:LMP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20141 FOREST PARK DR NE
Mailing Address - Street 2:
Mailing Address - City:SHORELINE
Mailing Address - State:WA
Mailing Address - Zip Code:98155-1152
Mailing Address - Country:US
Mailing Address - Phone:206-782-9121
Mailing Address - Fax:
Practice Address - Street 1:6823 OSWEGO PL NE
Practice Address - Street 2:SUITE #1
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98115-8415
Practice Address - Country:US
Practice Address - Phone:206-527-9709
Practice Address - Fax:206-526-2991
Is Sole Proprietor?:No
Enumeration Date:2007-04-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA00013270174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA20-1631890OtherTAX ID #