Provider Demographics
NPI:1699850834
Name:MILLER, JILL TRUEX (MD)
Entity Type:Individual
Prefix:
First Name:JILL
Middle Name:TRUEX
Last Name:MILLER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:JILL
Other - Middle Name:BETH
Other - Last Name:TRUEX
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:17000 140TH AVE NE
Mailing Address - Street 2:SUITE 102
Mailing Address - City:WOODINVILLE
Mailing Address - State:WA
Mailing Address - Zip Code:98072
Mailing Address - Country:US
Mailing Address - Phone:425-483-5437
Mailing Address - Fax:425-488-4919
Practice Address - Street 1:17000 140TH AVE NE
Practice Address - Street 2:SUITE 102
Practice Address - City:WOODINVILLE
Practice Address - State:WA
Practice Address - Zip Code:98072
Practice Address - Country:US
Practice Address - Phone:425-483-5437
Practice Address - Fax:425-488-4919
Is Sole Proprietor?:No
Enumeration Date:2006-10-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD00032912208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA7160179Medicaid