Individual
ROBERTA LEE MILLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MAC, SAP, CADC III
Contact information
Practice address
811 NW 20TH AVE, SUITE 103C, PORTLAND, OR 97209
(503) 816-0345
(503) 293-6188
Mailing address
PO BOX 10924, PORTLAND, OR 97296
(503) 816-0345
(503) 293-6188
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
05-11-98
OR
101YA0400X
Addiction (Substance Use Disorder) Counselor
507104
—
101YA0400X
Addiction (Substance Use Disorder) Counselor
CP00005706
WA
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
251S00000X
Community/Behavioral Health Agency
Primary
—
OR
Other
Enumeration date
03/10/2010
Last updated
09/13/2013
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