Individual
JEREMY WILSON MILLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT, DPT
Contact information
Practice address
3121 E MADISON ST STE 201, SEATTLE, WA 98112-4259
(206) 324-5389
(206) 324-5391
Mailing address
16083 SW UPPER BOONES FERRY RD STE 300, TIGARD, OR 97224-7736
(800) 219-8835
(503) 639-9699
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT60742902
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1912436445
MEDICARE
WA
01
—
G8968027
MEDICARE
WA
Enumeration date
06/08/2017
Last updated
07/31/2017
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