Individual
JANNA RUBERRY SULLIVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
2235 LAKE HEIGHTS DR, EVERETT, WA 98208-6030
(425) 338-3000
Mailing address
25117 SW PARKWAY AVE STE D, WILSONVILLE, OR 97070-9697
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
P1 60504799
WA
Other
Enumeration date
03/24/2015
Last updated
03/24/2015
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