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Individual
MEAGAN A SULLIVAN-PRUYN
Active
Individual
MEAGAN A SULLIVAN-PRUYN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA60435682
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1689090722
—
WA
Enumeration date
03/13/2014
Last updated
11/26/2019
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