Provider Demographics
NPI:1639958127
Name:MILLER, ANNA (ND)
Entity type:Individual
Prefix:
First Name:ANNA
Middle Name:
Last Name:MILLER
Suffix:
Gender:F
Credentials:ND
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15109 122ND CT NE
Mailing Address - Street 2:
Mailing Address - City:KIRKLAND
Mailing Address - State:WA
Mailing Address - Zip Code:98034-4547
Mailing Address - Country:US
Mailing Address - Phone:509-379-4925
Mailing Address - Fax:
Practice Address - Street 1:21616 76TH AVE W STE 209
Practice Address - Street 2:
Practice Address - City:EDMONDS
Practice Address - State:WA
Practice Address - Zip Code:98026-7512
Practice Address - Country:US
Practice Address - Phone:425-678-8205
Practice Address - Fax:425-678-8241
Is Sole Proprietor?:No
Enumeration Date:2023-09-25
Last Update Date:2024-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WANT61490164175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath