Provider Demographics
NPI:1912073545
Name:MILLER, LINDA GAY (LMP)
Entity Type:Individual
Prefix:MS
First Name:LINDA
Middle Name:GAY
Last Name:MILLER
Suffix:
Gender:F
Credentials:LMP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4808 GAY RD E
Mailing Address - Street 2:
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98443
Mailing Address - Country:US
Mailing Address - Phone:253-926-8930
Mailing Address - Fax:
Practice Address - Street 1:KRONLUND CHIROPRACTIC CLINIC PS
Practice Address - Street 2:3820 SO 320TH
Practice Address - City:AUBURN
Practice Address - State:WA
Practice Address - Zip Code:98001
Practice Address - Country:US
Practice Address - Phone:253-839-2650
Practice Address - Fax:253-839-4528
Is Sole Proprietor?:No
Enumeration Date:2006-11-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA00022084225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA0208392OtherDEPT LABOR OF INDUSTRIES
WAMA00022084OtherSTATE MASSAGE LISCENSE