Provider Demographics
NPI:1467854752
Name:MILLER, AMY LAUREL (PA-C)
Entity type:Individual
Prefix:
First Name:AMY
Middle Name:LAUREL
Last Name:MILLER
Suffix:
Gender:F
Credentials:PA-C
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Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:352 HARRISON RD
Mailing Address - Street 2:
Mailing Address - City:SELAH
Mailing Address - State:WA
Mailing Address - Zip Code:98942-9505
Mailing Address - Country:US
Mailing Address - Phone:509-697-6101
Mailing Address - Fax:509-697-5464
Practice Address - Street 1:352 HARRISON RD
Practice Address - Street 2:
Practice Address - City:SELAH
Practice Address - State:WA
Practice Address - Zip Code:98942-9505
Practice Address - Country:US
Practice Address - Phone:509-697-6101
Practice Address - Fax:509-697-5464
Is Sole Proprietor?:No
Enumeration Date:2014-09-18
Last Update Date:2025-08-06
Deactivation Date:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical