Organization
LIGHTHOUSE FAMILY CLINIC LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
WILLIAM THOMAS MILLER ARNP (OWNER)
(360) 940-7465
Entity
Organization
Contact information
Practice address
114 E CHANCE A LA MER NE, # 107, OCEAN SHORES, WA 98569-9202
(360) 940-7465
Mailing address
PO BOX 1574, OCEAN SHORES, WA 98569-1574
(360) 940-7465
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
AP60249842
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2014973
—
WA
01
—
603-142-599
UBI NUMBER
—
Enumeration date
11/29/2011
Last updated
03/07/2023
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