Individual provider Active NPI

Bryan Herbert Miller, LMT

  • Specialist
  • Portland, OR
National Provider Identifier
1821221532
Registry record updated Aug 27, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
13745 Issued in OR
Practice address
118 N Killingsworth St
Portland, OR 97217-2435
Phone
(503) 288-4454
NPI assigned
Aug 27, 2009
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 27, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 13745 OR Primary

Addresses

Primary practice location

118 N Killingsworth St
Portland, OR 97217-2435

Mailing address

3736 N Gantenbein Ave
Portland, OR 97227-1415
Phone (503) 593-0352

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
13745ORMDSpecialist

NPI Registry JSON

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

{
    "created_epoch": "1251331200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1251331200000",
    "number": "1821221532",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3736 N GANTENBEIN AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972271415",
            "telephone_number": "503-593-0352"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "118 N KILLINGSWORTH ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972172435",
            "telephone_number": "503-288-4454"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLER",
        "first_name": "BRYAN",
        "middle_name": "HERBERT",
        "name_prefix": "Mr.",
        "credential": "LMT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-08-27",
        "last_updated": "2009-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "OR",
            "license": "13745",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2009; 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.