Provider Demographics
NPI:1427203082
Name:MILLS, CARRIE ANN (BS, LMT)
Entity Type:Individual
Prefix:
First Name:CARRIE
Middle Name:ANN
Last Name:MILLS
Suffix:
Gender:F
Credentials:BS, LMT
Other - Prefix:
Other - First Name:CARRIE
Other - Middle Name:ANN
Other - Last Name:KUGLER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 3760
Mailing Address - Street 2:
Mailing Address - City:HILLSBORO
Mailing Address - State:OR
Mailing Address - Zip Code:97123-1948
Mailing Address - Country:US
Mailing Address - Phone:503-351-3557
Mailing Address - Fax:503-628-0603
Practice Address - Street 1:3800 SW CEDAR HILLS BLVD
Practice Address - Street 2:SUITE #193
Practice Address - City:BEAVERTON
Practice Address - State:OR
Practice Address - Zip Code:97005-2027
Practice Address - Country:US
Practice Address - Phone:503-643-3827
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-24
Last Update Date:2008-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR6187225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist