Provider Demographics
NPI:1851434823
Name:MILLER, PAMELA (PHD)
Entity Type:Individual
Prefix:DR
First Name:PAMELA
Middle Name:
Last Name:MILLER
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:321 W 4TH ST
Mailing Address - Street 2:
Mailing Address - City:THE DALLES
Mailing Address - State:OR
Mailing Address - Zip Code:97058-1807
Mailing Address - Country:US
Mailing Address - Phone:541-298-3294
Mailing Address - Fax:
Practice Address - Street 1:321 W 4TH ST
Practice Address - Street 2:
Practice Address - City:THE DALLES
Practice Address - State:OR
Practice Address - Zip Code:97058-1807
Practice Address - Country:US
Practice Address - Phone:541-298-3294
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-15
Last Update Date:2011-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR1394103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
ORP00064849OtherRAILROAD MEDICARE
OR041473000OtherREGENCE BCBSO
OR251030OtherMANAGED HEALTH NETWORK
OR236999Medicaid
OR251030OtherMANAGED HEALTH NETWORK
OR041473000OtherREGENCE BCBSO