Individual
SHELLY D MILLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
3322 BROADWAY, 2 SOUTH, EVERETT, WA 98201-4425
(425) 349-7289
Mailing address
4526 FEDERAL AVE, EVERETT, WA 98203-2132
(425) 349-6200
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN60331698
WA
163WP0808X
Psychiatric/Mental Health Registered Nurse
Primary
RN60331698
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
RN60331698
RN LICENSE
WA
Enumeration date
07/01/2014
Last updated
07/10/2020
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