Individual
MS. JOANNA KATHLEEN SULLIVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNM
Contact information
Practice address
106 SW WOODS ST, PORTLAND, OR 97201-4739
(503) 862-8088
(503) 567-6443
Mailing address
PO BOX 67127, PORTLAND, OR 97268-1127
(503) 862-8088
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
201050203NP
OR
367A00000X
Advanced Practice Midwife
201050203NP
OR
Other
Enumeration date
08/19/2010
Last updated
08/19/2025
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