Individual
NISHIE SHANEE MILLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
3629 S D ST, TACOMA, WA 98418-6813
(253) 649-1406
Mailing address
3629 S D ST, TACOMA, WA 98418-6813
(253) 649-1406
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
LP60553540
WA
Other
Enumeration date
12/28/2020
Last updated
12/28/2020
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