Provider Demographics
NPI:1396951950
Name:MILLER, RONALD JOHN (MS, LMFT)
Entity type:Individual
Prefix:MR
First Name:RONALD
Middle Name:JOHN
Last Name:MILLER
Suffix:
Gender:M
Credentials:MS, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 65428
Mailing Address - Street 2:
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98665-0015
Mailing Address - Country:US
Mailing Address - Phone:360-694-5212
Mailing Address - Fax:866-866-7650
Practice Address - Street 1:207 E 19TH ST
Practice Address - Street 2:
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98663-3301
Practice Address - Country:US
Practice Address - Phone:360-694-5212
Practice Address - Fax:866-866-7650
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALH00005619101YM0800X
WALF00000890106H00000X
ORT0224106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Not Answered106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist