Provider Demographics
NPI:1528251774
Name:MILLER, BRADY MORROW (PHD)
Entity type:Individual
Prefix:DR
First Name:BRADY
Middle Name:MORROW
Last Name:MILLER
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1800 112TH AVE NE
Mailing Address - Street 2:SUITE 240-W
Mailing Address - City:BELLEVUE
Mailing Address - State:WA
Mailing Address - Zip Code:98004-2993
Mailing Address - Country:US
Mailing Address - Phone:425-224-5775
Mailing Address - Fax:
Practice Address - Street 1:1800 112TH AVE NE
Practice Address - Street 2:SUITE 240-W
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98004-2993
Practice Address - Country:US
Practice Address - Phone:425-224-5775
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-21
Last Update Date:2011-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMC60190842101YM0800X
WAPY 60200533103TC2200X
WAPY60200533103TC0700X, 103TB0200X, 103TF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & Adolescent
No103TB0200XBehavioral Health & Social Service ProvidersPsychologistCognitive & Behavioral
No103TF0000XBehavioral Health & Social Service ProvidersPsychologistFamily