Provider Demographics
NPI:1558508812
Name:MILLER, ALIE M (LMP)
Entity type:Individual
Prefix:MRS
First Name:ALIE
Middle Name:M
Last Name:MILLER
Suffix:
Gender:F
Credentials:LMP
Other - Prefix:
Other - First Name:ALIS
Other - Middle Name:M
Other - Last Name:BROWN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMP
Mailing Address - Street 1:903 5TH AVE
Mailing Address - Street 2:SUITE 102
Mailing Address - City:KIRKLAND
Mailing Address - State:WA
Mailing Address - Zip Code:98033-6348
Mailing Address - Country:US
Mailing Address - Phone:206-250-0550
Mailing Address - Fax:
Practice Address - Street 1:903 5TH AVE
Practice Address - Street 2:SUITE 102
Practice Address - City:KIRKLAND
Practice Address - State:WA
Practice Address - Zip Code:98033-6348
Practice Address - Country:US
Practice Address - Phone:206-250-0550
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-01-08
Last Update Date:2014-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA00014548174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist