Provider Demographics
NPI:1104830751
Name:MILLER, RUTH W (MD)
Entity Type:Individual
Prefix:DR
First Name:RUTH
Middle Name:W
Last Name:MILLER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1300 116TH AVE NE
Mailing Address - Street 2:
Mailing Address - City:BELLEVUE
Mailing Address - State:WA
Mailing Address - Zip Code:98004
Mailing Address - Country:US
Mailing Address - Phone:425-454-7912
Mailing Address - Fax:425-454-7034
Practice Address - Street 1:1300 116TH AVE NE
Practice Address - Street 2:
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98004
Practice Address - Country:US
Practice Address - Phone:425-454-7912
Practice Address - Fax:425-454-7034
Is Sole Proprietor?:No
Enumeration Date:2006-07-28
Last Update Date:2011-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD00035751207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA8225229Medicaid
WAMI5392OtherBLUE SHIELD
WAAB03531Medicare ID - Type Unspecified
G76717Medicare UPIN