Provider Demographics
NPI:1598351751
Name:MILES, MARGOT (CHT)
Entity Type:Individual
Prefix:
First Name:MARGOT
Middle Name:
Last Name:MILES
Suffix:
Gender:F
Credentials:CHT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15110 BOONES FERRY RD STE 300D
Mailing Address - Street 2:
Mailing Address - City:LAKE OSWEGO
Mailing Address - State:OR
Mailing Address - Zip Code:97035-3460
Mailing Address - Country:US
Mailing Address - Phone:503-442-6221
Mailing Address - Fax:
Practice Address - Street 1:15110 BOONES FERRY RD STE 300D
Practice Address - Street 2:
Practice Address - City:LAKE OSWEGO
Practice Address - State:OR
Practice Address - Zip Code:97035-3460
Practice Address - Country:US
Practice Address - Phone:503-442-6221
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-11
Last Update Date:2020-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Single Specialty
No133NN1002XDietary & Nutritional Service ProvidersNutritionistNutrition, EducationGroup - Single Specialty