# DR GERALD W MILLER MD PC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1386971836
- **Authorized official:** DR. GERALD WENDALL MILLER MD (CEO)
- **Authorized official phone:** (503) 466-1823

## Contact information

- **Practice address:** 1960 NW 167TH PL, SUITE 103, BEAVERTON, OR 97006-4803
- **Practice address phone:** (503) 466-1823
- **Practice address fax:** (503) 466-2045
- **Mailing address:** 1960 NW 167TH PL, SUITE 103, BEAVERTON, OR 97006-4803
- **Mailing address phone:** (503) 466-1823
- **Mailing address fax:** (503) 466-2045

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QM1300X | Multi-Specialty Clinic/Center | MD16819 | OR | Yes |

## Other

- **Enumeration date:** 11/04/2009
- **Last updated:** 11/04/2009