Individual
RUSSELL MILLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CP
Contact information
Practice address
3508 12TH AVE NE, OLYMPIA, WA 98506-5218
(360) 459-1099
(360) 459-1794
Mailing address
3508 12TH AVE NE, OLYMPIA, WA 98506-5218
(360) 459-1099
(360) 459-1794
Taxonomy
Speciality
Code
Description
License number
State
224P00000X
Prosthetist
Primary
PS 60371032
WA
Other
Enumeration date
09/03/2013
Last updated
09/03/2013
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