Organization
DR GERALD W MILLER MD PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GERALD WENDALL MILLER MD (CEO)
(503) 466-1823
Entity
Organization
Contact information
Practice address
1960 NW 167TH PL, SUITE 103, BEAVERTON, OR 97006-4803
(503) 466-1823
(503) 466-2045
Mailing address
1960 NW 167TH PL, SUITE 103, BEAVERTON, OR 97006-4803
(503) 466-1823
(503) 466-2045
Taxonomy
Speciality
Code
Description
License number
State
261QM1300X
Multi-Specialty Clinic/Center
Primary
MD16819
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
021977
—
OR
05
—
8140758
—
WA
Enumeration date
11/04/2009
Last updated
11/04/2009
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