Provider Demographics
NPI:1780802967
Name:MILLER, MARGERY F (PT)
Entity type:Individual
Prefix:MS
First Name:MARGERY
Middle Name:F
Last Name:MILLER
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15375 HARVEY RD NE
Mailing Address - Street 2:
Mailing Address - City:BAINBRIDGE IS
Mailing Address - State:WA
Mailing Address - Zip Code:98110-3005
Mailing Address - Country:US
Mailing Address - Phone:206-842-1847
Mailing Address - Fax:
Practice Address - Street 1:19319 7TH AVE NE
Practice Address - Street 2:SUITE 100
Practice Address - City:POULSBO
Practice Address - State:WA
Practice Address - Zip Code:98370-7442
Practice Address - Country:US
Practice Address - Phone:360-779-3764
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-23
Last Update Date:2011-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPT00006992225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA8351660Medicaid
123256OtherWA. LABOR AND INDUSTRIES
123256OtherWA. LABOR AND INDUSTRIES
WA8351660Medicaid