Individual
JASON RONALD MILLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LPN
Contact information
Practice address
11309 NE 359TH ST, LA CENTER, WA 98629-3643
(360) 907-2782
(360) 263-6544
Mailing address
11309 NE 359TH ST, LA CENTER, WA 98629-3643
(360) 907-2782
(360) 263-6544
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
LP60272616
WA
Other
Enumeration date
05/23/2012
Last updated
05/23/2012
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