Individual
DR. ALLEN MILLARD III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1701 N 13TH ST, SHELTON, WA 98584-2077
(360) 426-2653
Mailing address
PO BOX 1668, SHELTON, WA 98584-5001
(360) 426-2653
(360) 462-2500
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD00025623
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8117525
—
WA
Enumeration date
09/27/2005
Last updated
02/04/2021
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