Provider Demographics
NPI:1629346986
Name:MILLER, CINDY (LMP)
Entity Type:Individual
Prefix:
First Name:CINDY
Middle Name:
Last Name:MILLER
Suffix:
Gender:F
Credentials:LMP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:744 MARKET ST
Mailing Address - Street 2:SUITE 102A
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98402-3700
Mailing Address - Country:US
Mailing Address - Phone:253-272-9500
Mailing Address - Fax:
Practice Address - Street 1:744 MARKET ST
Practice Address - Street 2:SUITE 102A
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98402-3700
Practice Address - Country:US
Practice Address - Phone:253-272-9500
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-12-01
Last Update Date:2011-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA00019083225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist