Individual
SAMUEL KINGSBURY MILLETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-S
Contact information
Practice address
2330 S HIGGINS AVE, MISSOULA, MT 59801-6923
(206) 616-4001
Mailing address
4311 11TH AVE NE STE 200, SEATTLE, WA 98105-6367
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
95698
MT
363A00000X
Physician Assistant
PA9114327
FL
Other
Enumeration date
09/02/2017
Last updated
06/14/2022
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