Provider Demographics
NPI:1780132498
Name:MILLER, STEVEN R (PHARMD)
Entity type:Individual
Prefix:
First Name:STEVEN
Middle Name:R
Last Name:MILLER
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7591 CRATER LAKE HWY
Mailing Address - Street 2:
Mailing Address - City:WHITE CITY
Mailing Address - State:OR
Mailing Address - Zip Code:97503-1663
Mailing Address - Country:US
Mailing Address - Phone:541-826-4414
Mailing Address - Fax:541-826-8366
Practice Address - Street 1:7591 CRATER LAKE HWY
Practice Address - Street 2:
Practice Address - City:WHITE CITY
Practice Address - State:OR
Practice Address - Zip Code:97503-1663
Practice Address - Country:US
Practice Address - Phone:541-826-4414
Practice Address - Fax:541-826-8366
Is Sole Proprietor?:Yes
Enumeration Date:2016-09-12
Last Update Date:2020-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR0015555183500000X, 1835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
No183500000XPharmacy Service ProvidersPharmacist