Individual
C. SUNFLOWER MILES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
741 N COLONYSURF DR, LILLIWAUP, WA 98555-9855
(253) 261-6961
Mailing address
741 N COLONY SURF DR, LILLIWAUP, WA 98555-9782
(253) 261-6961
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
RN612122141
WA
164W00000X
Licensed Practical Nurse
60434991
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
604477393
UNIFORM BUSINESS NUMBER
WA
Enumeration date
08/29/2019
Last updated
02/17/2022
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