Active NPI
Kenneth A Miles, PH.D.
- Clinical Child & Adolescent Psychologist
- Tacoma, WA
National Provider Identifier
1962588616
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Child & Adolescent Psychologist
- License
- 2264
- Practice address
- Madigan Army Medical Center Attn: Kenneth a Miles, PH.D
9040 Jackson Ave
Tacoma, WA 98431 - Phone
- (253) 968-2310
- NPI assigned
- Oct 27, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Child & Adolescent Psychologist | 103TC2200X | 2264 | WA | Primary |
Addresses
Primary practice location
Madigan Army Medical Center Attn: Kenneth a Miles, PH.D
9040 Jackson Ave
Tacoma, WA 98431
Mailing address
Madigan Army Medical Center Attn: Kenneth a Miles, PH.D
9040 Jackson Ave
Tacoma, WA 98431
Phone (253) 968-2310
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
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2264 | WA | MD | Clinical Child & Adolescent Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1161907200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1552003200000",
"number": "1962588616",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "MADIGAN ARMY MEDICAL CENTER ATTN: KENNETH A MILES, PH.D",
"address_2": "9040 JACKSON AVE",
"city": "TACOMA",
"state": "WA",
"postal_code": "98431",
"telephone_number": "253-968-2310"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "MADIGAN ARMY MEDICAL CENTER ATTN: KENNETH A MILES, PH.D",
"address_2": "9040 JACKSON AVE",
"city": "TACOMA",
"state": "WA",
"postal_code": "98431",
"telephone_number": "253-968-2310"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MILES",
"first_name": "KENNETH",
"middle_name": "A",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-10-27",
"last_updated": "2019-03-08",
"status": "A"
},
"taxonomies": [
{
"code": "103TC2200X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical Child & Adolescent",
"state": "WA",
"license": "2264",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Tacoma, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 8, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.