Basic Information
| Provider Information | |||||||||
| NPI: | 1235391475 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | MILLER | ||||||||
| FirstName: | ANNE | ||||||||
| MiddleName: | ELIZABETH | ||||||||
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| Credential: | LMFT | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3 MONROE PKWY | ||||||||
| Address2: | SUITE P #136 | ||||||||
| City: | LAKE OSWEGO | ||||||||
| State: | OR | ||||||||
| PostalCode: | 970351486 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5034425857 | ||||||||
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| Practice Location | |||||||||
| Address1: | 3550 SE WOODWARD ST | ||||||||
| Address2: | |||||||||
| City: | PORTLAND | ||||||||
| State: | OR | ||||||||
| PostalCode: | 972021552 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5038674719 | ||||||||
| FaxNumber: | 5039434994 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/30/2008 | ||||||||
| LastUpdateDate: | 06/30/2008 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 106H00000X | T0584 | OR | Y | Behavioral Health & Social Service Providers | Marriage & Family Therapist |
No ID Information.