Provider Demographics
NPI:1801905815
Name:MILLER, DANIEL (MA ; MHP; LMHC)
Entity type:Individual
Prefix:
First Name:DANIEL
Middle Name:
Last Name:MILLER
Suffix:
Gender:M
Credentials:MA ; MHP; LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18039 25TH AVE NE
Mailing Address - Street 2:
Mailing Address - City:SHORELINE
Mailing Address - State:WA
Mailing Address - Zip Code:98155-3905
Mailing Address - Country:US
Mailing Address - Phone:425-774-4269
Mailing Address - Fax:
Practice Address - Street 1:16150 NE 85TH ST
Practice Address - Street 2:SUITE 222
Practice Address - City:REDMOND
Practice Address - State:WA
Practice Address - Zip Code:98052-3539
Practice Address - Country:US
Practice Address - Phone:425-869-6687
Practice Address - Fax:877-880-4388
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-30
Last Update Date:2010-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
251K00000X
WALH60018127103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No251K00000XAgenciesPublic Health or Welfare