Provider Demographics
NPI:1932370335
Name:MILLER, CAMILLE AVINA (MD)
Entity Type:Individual
Prefix:
First Name:CAMILLE
Middle Name:AVINA
Last Name:MILLER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:CAMILLE
Other - Middle Name:AVINA
Other - Last Name:RILEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2940 SQUALICUM PKWY STE 204
Mailing Address - Street 2:
Mailing Address - City:BELLINGHAM
Mailing Address - State:WA
Mailing Address - Zip Code:98225-1892
Mailing Address - Country:US
Mailing Address - Phone:360-733-0070
Mailing Address - Fax:360-676-8351
Practice Address - Street 1:2940 SQUALICUM PKWY STE 204
Practice Address - Street 2:
Practice Address - City:BELLINGHAM
Practice Address - State:WA
Practice Address - Zip Code:98225-1892
Practice Address - Country:US
Practice Address - Phone:360-733-0070
Practice Address - Fax:360-676-8351
Is Sole Proprietor?:No
Enumeration Date:2008-03-13
Last Update Date:2020-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA90872208600000X
WAMD60012912208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery