| Dr Gerald W Miller Md Pc | |
|
1960 Nw 167th Pl Suite 103 Beaverton OR 97006-4803 | |
| (503) 466-1823 | |
| (503) 466-2045 |
| Full Name | Dr Gerald W Miller Md Pc |
|---|---|
| Speciality | Clinic/center - Multi-specialty |
| Location | 1960 Nw 167th Pl, Beaverton, Oregon |
| Authorized Official Name and Position | Gerald Wendall Miller (CEO) |
| Authorized Official Contact | 5034661823 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Gerald W Miller Md Pc 1960 Nw 167th Pl Suite 103 Beaverton OR 97006-4803 Ph: (503) 466-1823 | Dr Gerald W Miller Md Pc 1960 Nw 167th Pl Suite 103 Beaverton OR 97006-4803 Ph: (503) 466-1823 |
| NPI Number | 1386971836 |
|---|---|
| Provider Enumeration Date | 11/04/2009 |
| Last Update Date | 11/04/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1386971836 | NPI | - | NPPES |
| 8140758 | Medicaid | WA | |
| 021977 | Medicaid | OR |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM1300X | Clinic/center - Multi-specialty | MD16819 (Oregon) | Primary |
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