Individual
MS. LISA JILL MILLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
4540 NE GLISAN, PORTLAND, OR 97213
(503) 215-3738
Mailing address
7728 SE 7TH AVE, PORTLAND, OR 97202
(503) 233-6462
Taxonomy
Speciality
Code
Description
License number
State
163WG0600X
Gerontology Registered Nurse
Primary
095000495RN
OR
Other
Enumeration date
09/06/2012
Last updated
09/06/2012
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