Organization
KEITH MILLER OD PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KEITH MILLER OD (OWNER)
(503) 860-6399
Entity
Organization
Contact information
Practice address
11800 SE 82ND AVE, HAPPY VALLEY, OR 97086
(503) 786-5235
(503) 654-5429
Mailing address
11800 SE 82ND AVE, HAPPY VALLEY, OR 97086
(503) 786-5235
(503) 654-5429
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1654AT
OR
152W00000X
Optometrist
OD00003109
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500691425
—
OR
Enumeration date
06/02/2008
Last updated
09/29/2016
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