Provider Demographics
NPI:1669735304
Name:JOHN S MILLER, DC, DACBR, PS
Entity type:Organization
Organization Name:JOHN S MILLER, DC, DACBR, PS
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:S
Authorized Official - Last Name:MILLER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:206-784-8119
Mailing Address - Street 1:9015 HOLMAN RD NW
Mailing Address - Street 2:SUITE 3
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98117-3481
Mailing Address - Country:US
Mailing Address - Phone:206-784-8119
Mailing Address - Fax:206-784-4020
Practice Address - Street 1:9015 HOLMAN RD NW
Practice Address - Street 2:SUITE 3
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98117-3481
Practice Address - Country:US
Practice Address - Phone:206-784-8119
Practice Address - Fax:206-784-4020
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-06-18
Last Update Date:2012-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACH00002256111NR0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NR0200XChiropractic ProvidersChiropractorRadiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA000109247Medicare PIN