Individual
JACOB DARRIS MILLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
B.A.
Contact information
Practice address
1100 SOUTH 2ND STREET, MOUNT VERNON, WA 98273
(360) 419-3523
(360) 419-3535
Mailing address
PO BOX 3810, EVERETT, WA 98213
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
04/03/2014
Last updated
04/03/2014
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