Provider Demographics
NPI:1841385507
Name:MILLER, ELIZABETH JOAN (MSW,QMHP,CADC)
Entity Type:Individual
Prefix:MS
First Name:ELIZABETH
Middle Name:JOAN
Last Name:MILLER
Suffix:
Gender:F
Credentials:MSW,QMHP,CADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3911 SE MALL ST
Mailing Address - Street 2:APT 2D
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97202-9102
Mailing Address - Country:US
Mailing Address - Phone:971-227-5783
Mailing Address - Fax:
Practice Address - Street 1:945 NE 165TH AVE
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97230-6148
Practice Address - Country:US
Practice Address - Phone:503-408-8100
Practice Address - Fax:503-408-8384
Is Sole Proprietor?:No
Enumeration Date:2006-10-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Not Answered101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Not Answered1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical