Individual
ANNETTE JANE MILES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PWS
Contact information
Practice address
1741 NEWMARK AVE, COOS BAY, OR 97420-4704
(458) 710-8184
Mailing address
PO BOX 1121, ROSEBURG, OR 97470-0254
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
THW000106420
OHA
OR
Enumeration date
06/29/2022
Last updated
06/24/2025
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