Individual
EDWARD BRADDOCK SULLIVAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
3857 MARTIN WAY E, OLYMPIA, WA 98506-5268
(360) 704-7170
Mailing address
3857 MARTIN WAY E, OLYMPIA, WA 98506-5268
(253) 312-9057
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
04/08/2021
Last updated
04/08/2021
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