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Individual
KATRINA SULLIVAN
Active
Individual
KATRINA SULLIVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DPM
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
PO00000428
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1063833
—
WA
01
—
2976
INTERNAL ID-MOTOR VEHICLE ID
—
Enumeration date
10/27/2006
Last updated
10/25/2007
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