Provider Demographics
NPI:1134334436
Name:MILLER-STONE, HOLLY B (LMP)
Entity type:Individual
Prefix:MRS
First Name:HOLLY
Middle Name:B
Last Name:MILLER-STONE
Suffix:
Gender:F
Credentials:LMP
Other - Prefix:
Other - First Name:HOLLY
Other - Middle Name:
Other - Last Name:MILLER-STONE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:16500 SE 15TH ST
Mailing Address - Street 2:SUITE 160
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98683-9665
Mailing Address - Country:US
Mailing Address - Phone:360-882-8222
Mailing Address - Fax:
Practice Address - Street 1:16500 SE 15TH ST
Practice Address - Street 2:SUITE 160
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98683-9665
Practice Address - Country:US
Practice Address - Phone:360-882-8222
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA00014001225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist