Provider Demographics
NPI:1275377715
Name:MILLER, DYLAN (DNP)
Entity type:Individual
Prefix:DR
First Name:DYLAN
Middle Name:
Last Name:MILLER
Suffix:
Gender:M
Credentials:DNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1620 14TH AVE UNIT 4
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98122-4064
Mailing Address - Country:US
Mailing Address - Phone:360-775-6157
Mailing Address - Fax:
Practice Address - Street 1:1620 14TH AVE UNIT 4
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98122-4064
Practice Address - Country:US
Practice Address - Phone:360-775-6157
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-06-20
Last Update Date:2024-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARN61206990163W00000X
WAAP61599244363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163W00000XNursing Service ProvidersRegistered Nurse