Individual
MADELINE MILLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3415 SE POWELL BLVD, PORTLAND, OR 97202-3371
(503) 729-6177
Mailing address
6812 SW 10TH AVE, PORTLAND, OR 97219-2119
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
A11960
OR
Other
Enumeration date
12/12/2017
Last updated
09/24/2024
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