Provider Demographics
NPI:1831179977
Name:MILLER, CAMARON A
Entity type:Individual
Prefix:
First Name:CAMARON
Middle Name:A
Last Name:MILLER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:CAMARON
Other - Middle Name:
Other - Last Name:MILLER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2420 S UNION AVE
Mailing Address - Street 2:SUITE 130
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98405-1322
Mailing Address - Country:US
Mailing Address - Phone:253-752-1070
Mailing Address - Fax:253-752-2315
Practice Address - Street 1:2420 S UNION AVE
Practice Address - Street 2:SUITE 130
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98405-1322
Practice Address - Country:US
Practice Address - Phone:253-752-1070
Practice Address - Fax:253-752-2315
Is Sole Proprietor?:No
Enumeration Date:2006-01-17
Last Update Date:2015-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPT00008149225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist