Individual
MARY KAY MILLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ANP
Contact information
Practice address
4999 SKYLINE RD S, SALEM, OR 97306-2878
(503) 364-4005
(503) 364-4006
Mailing address
PO BOX 1517, PENDLETON, OR 97801-0410
(877) 708-1119
(541) 278-8349
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
088007213
OR
Other
Enumeration date
03/14/2006
Last updated
02/06/2023
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