Provider Demographics
NPI:1366271363
Name:MILLER-CONLEY, CARRIE (OTR, OTD)
Entity type:Individual
Prefix:
First Name:CARRIE
Middle Name:
Last Name:MILLER-CONLEY
Suffix:
Gender:F
Credentials:OTR, OTD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 946
Mailing Address - Street 2:
Mailing Address - City:CANBY
Mailing Address - State:OR
Mailing Address - Zip Code:97013-0946
Mailing Address - Country:US
Mailing Address - Phone:503-908-6120
Mailing Address - Fax:971-244-9044
Practice Address - Street 1:355 N HOLLY ST
Practice Address - Street 2:
Practice Address - City:CANBY
Practice Address - State:OR
Practice Address - Zip Code:97013
Practice Address - Country:US
Practice Address - Phone:503-908-6120
Practice Address - Fax:971-244-9044
Is Sole Proprietor?:No
Enumeration Date:2024-07-29
Last Update Date:2024-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR516537225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist