Andrea Nichole Miller, AT/C, AT/L

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

A1 60066953 Issued in WA

Practice address

4606 Bridgeport Way W
#C
University Place, WA 98466-4200

Phone

(253) 565-3551

Fax

(253) 565-4535

NPI assigned

Jul 22, 2010

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• McRae and Radonich Inc PS

  • Physical Therapist
  • University Place, WA
  • NPI 1326062191
  NPD (past)
• Quenga, Hanson and Purdue, P.S., Inc.

  • Physical Therapist
  • University Place, WA
  • NPI 1871082974
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1279756800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1279756800000",
    "number": "1508179235",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4606 BRIDGEPORT WAY W",
            "address_2": "#C",
            "city": "UNIVERSITY PLACE",
            "state": "WA",
            "postal_code": "984664200",
            "telephone_number": "253-565-3551",
            "fax_number": "253-565-4535"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4606 BRIDGEPORT WAY W",
            "address_2": "#C",
            "city": "UNIVERSITY PLACE",
            "state": "WA",
            "postal_code": "984664200",
            "telephone_number": "253-565-3551",
            "fax_number": "253-565-4535"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLER",
        "first_name": "ANDREA",
        "middle_name": "NICHOLE",
        "name_prefix": "Ms.",
        "credential": "AT/C, AT/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-07-22",
        "last_updated": "2010-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "WA",
            "license": "A1 60066953",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• John Gary Meyer, M.D.
• Marcy Meyer, M.D.
• Michael R. Jackson, M.D. P.S.
• Kimberly Shin Michie, PHARMD
• Lavonna Miesse
• Cameron Miller
• Emily Hope Milless
• Yuna Min
• Mindful Mental Health, PLLC
• Madeline Marie Miranda Garcia, LMFTA

• Athletic Trainer in University Place, WA
• Providers in University Place, WA by specialty
• Athletic Trainer in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.