# KENT N SULLIVAN MD PLLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1386004638
- **Authorized official:** DR. KENT N SULLIVAN MD (PHYSICIAN OWNER)
- **Authorized official phone:** (206) 406-5723

## Contact information

- **Practice address:** 19219 51ST AVE NE, LAKE FOREST PARK, WA 98155-2940
- **Practice address phone:** (206) 406-5723
- **Practice address fax:** (206) 527-0147
- **Mailing address:** 19219 51ST AVE NE, LAKE FOREST PARK, WA 98155-2940
- **Mailing address phone:** (206) 406-5723
- **Mailing address fax:** (206) 527-0147

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207RP1001X | Pulmonary Disease Physician | MD0001591 | WA | Yes |

## Other

- **Enumeration date:** 02/29/2016
- **Last updated:** 02/29/2016