Individual
GEORGE SULLIVAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
C.A.R. L.M.P.
Contact information
Practice address
1506 5TH AVE SW, OLYMPIA, WA 98502-5248
(360) 943-8470
Mailing address
1825 FOREST HILL DR SE, OLYMPIA, WA 98501-3736
(360) 943-8470
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
MA00013506
WA
Other
Enumeration date
02/28/2007
Last updated
07/08/2007
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