Individual
MISS SHANON LEA MILLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3900 PACIFIC AVE, FOREST GROVE, OR 97116-2226
(503) 359-0449
Mailing address
25117 SW PARKWAY AVE, SUITE D, WILSONVILLE, OR 97070-9697
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
09291
OR
Other
Enumeration date
05/09/2016
Last updated
05/09/2016
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