Individual
MS. BRENDA JEAN SULLIVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
720 SE WASHINGTON ST, HILLSBORO, OR 97123-4230
(503) 648-0753
Mailing address
8915 SW CENTER ST, TIGARD, OR 97223-6307
(503) 726-3690
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
—
OR
Other
Enumeration date
02/13/2015
Last updated
02/25/2019
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