Provider Demographics
NPI:1144972183
Name:MILLER, ALAINE ANETTE (MOT/OTRL)
Entity type:Individual
Prefix:
First Name:ALAINE
Middle Name:ANETTE
Last Name:MILLER
Suffix:
Gender:F
Credentials:MOT/OTRL
Other - Prefix:
Other - First Name:ALAINE
Other - Middle Name:ANETTE
Other - Last Name:AKINLUDE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:40899 WATERMAN RD
Mailing Address - Street 2:
Mailing Address - City:HOMER
Mailing Address - State:AK
Mailing Address - Zip Code:99603-9459
Mailing Address - Country:US
Mailing Address - Phone:734-846-9917
Mailing Address - Fax:
Practice Address - Street 1:18 1ST ST SE
Practice Address - Street 2:
Practice Address - City:AUBURN
Practice Address - State:WA
Practice Address - Zip Code:98002-5059
Practice Address - Country:US
Practice Address - Phone:253-336-5806
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-01-20
Last Update Date:2022-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT12494821-4201225X00000X
MI5201010425225X00000X
WA61226338225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist