Provider Demographics
NPI:1316935752
Name:MILLER, CATHLEEN J (MD)
Entity type:Individual
Prefix:DR
First Name:CATHLEEN
Middle Name:J
Last Name:MILLER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:2211 E MILL PLAIN BLVD
Mailing Address - Street 2:KAISER PERMANENTE VANCOUVER MEDICAL OFFICE
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98661-9926
Mailing Address - Country:US
Mailing Address - Phone:360-992-4172
Mailing Address - Fax:
Practice Address - Street 1:2211 E MILL PLAIN BLVD
Practice Address - Street 2:KAISER PERMANENTE VANCOUVER MEDICAL OFFICE
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98661-9926
Practice Address - Country:US
Practice Address - Phone:360-992-4172
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-10-10
Last Update Date:2022-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG684962084N0400X
ORMD242332084N0400X
WAMD000464842084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAF09541Medicare UPIN