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Individual

DR. KEITH LYNDON MILLER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
O.D.

Contact information

Practice address
136 NW SECOND STREET, STEVENSON, WA 98648
(509) 427-8259
(509) 427-8268
Mailing address
7667 SE LINCOLN ST, PORTLAND, OR 97215-4153
(509) 427-8259
(509) 427-8268

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
602829747
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
G8873418
WA
Enumeration date
07/12/2006
Last updated
08/17/2012
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