Individual
COLE MILLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PSS
Contact information
Practice address
8940 SE 72ND AVE, PORTLAND, OR 97206-9417
(503) 772-4110
Mailing address
8940 SE 72ND AVE, PORTLAND, OR 97206-9417
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
2364035
OR
Other
Enumeration date
06/24/2024
Last updated
06/24/2024
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