Provider Demographics
NPI:1225115488
Name:MILLER, MARY FRANCES (PHD)
Entity Type:Individual
Prefix:DR
First Name:MARY
Middle Name:FRANCES
Last Name:MILLER
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2020 E 29TH AVE
Mailing Address - Street 2:STE 210
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99203-3950
Mailing Address - Country:US
Mailing Address - Phone:509-838-8168
Mailing Address - Fax:509-838-8256
Practice Address - Street 1:2020 E 29TH AVE
Practice Address - Street 2:STE 210
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99203-3950
Practice Address - Country:US
Practice Address - Phone:509-838-8168
Practice Address - Fax:509-838-8256
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-01
Last Update Date:2018-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPY00001390103T00000X, 103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAR11366Medicare UPIN
WA000304195Medicare ID - Type Unspecified