Provider Demographics
NPI:1962727099
Name:MILLER, MARY-CLAIRE (ND)
Entity type:Individual
Prefix:DR
First Name:MARY-CLAIRE
Middle Name:
Last Name:MILLER
Suffix:
Gender:F
Credentials:ND
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21006 83RD AVE W
Mailing Address - Street 2:APT. 18
Mailing Address - City:EDMONDS
Mailing Address - State:WA
Mailing Address - Zip Code:98026-7053
Mailing Address - Country:US
Mailing Address - Phone:425-778-4291
Mailing Address - Fax:
Practice Address - Street 1:22617 76TH AVE W
Practice Address - Street 2:#106
Practice Address - City:EDMONDS
Practice Address - State:WA
Practice Address - Zip Code:98026-8316
Practice Address - Country:US
Practice Address - Phone:425-778-8050
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-31
Last Update Date:2010-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WANT00000983175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath