Provider Demographics
NPI:1861583767
Name:MILLER, ERIC W (DC)
Entity type:Individual
Prefix:
First Name:ERIC
Middle Name:W
Last Name:MILLER
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:873 BETHEL AVE
Mailing Address - Street 2:
Mailing Address - City:PORT ORCHARD
Mailing Address - State:WA
Mailing Address - Zip Code:98366-4229
Mailing Address - Country:US
Mailing Address - Phone:360-876-1500
Mailing Address - Fax:360-876-1666
Practice Address - Street 1:873 BETHEL AVE
Practice Address - Street 2:
Practice Address - City:PORT ORCHARD
Practice Address - State:WA
Practice Address - Zip Code:98366-4229
Practice Address - Country:US
Practice Address - Phone:360-876-1500
Practice Address - Fax:360-876-1666
Is Sole Proprietor?:No
Enumeration Date:2006-09-27
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA33957111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
0170638OtherLABOR - INDUSTRIES
0170638OtherLABOR - INDUSTRIES