Provider Demographics
NPI:1437897428
Name:MILLER, JIREH JAEL (LMHCA)
Entity Type:Individual
Prefix:
First Name:JIREH
Middle Name:JAEL
Last Name:MILLER
Suffix:
Gender:F
Credentials:LMHCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 64372
Mailing Address - Street 2:
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98464-0372
Mailing Address - Country:US
Mailing Address - Phone:253-948-2689
Mailing Address - Fax:
Practice Address - Street 1:612 113TH ST S
Practice Address - Street 2:
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98444-4902
Practice Address - Country:US
Practice Address - Phone:253-948-2689
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-05-20
Last Update Date:2022-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA61279905101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health