Provider Demographics
NPI:1639301963
Name:MILLER, LAURA DEAN (MA, RC)
Entity Type:Individual
Prefix:MS
First Name:LAURA
Middle Name:DEAN
Last Name:MILLER
Suffix:
Gender:F
Credentials:MA, RC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1600 E OLIVE ST
Mailing Address - Street 2:SOUND MENTAL HEALTH
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98122-2735
Mailing Address - Country:US
Mailing Address - Phone:206-302-2200
Mailing Address - Fax:206-302-2210
Practice Address - Street 1:3936 S KENYON ST
Practice Address - Street 2:KENYON HOUSE
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98118-4048
Practice Address - Country:US
Practice Address - Phone:206-302-2772
Practice Address - Fax:206-302-2769
Is Sole Proprietor?:No
Enumeration Date:2009-08-20
Last Update Date:2009-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARC00022697101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional