Individual
MARY ELIZABETH O'SULLIVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
AUDIOLOGIST
Contact information
Practice address
501 SE 172ND AVE, 230, VANCOUVER, WA 98684-9542
(360) 397-3920
Mailing address
700 NE 87TH AVE, VANCOUVER, WA 98664-1913
(360) 397-3352
(360) 604-1771
Taxonomy
Speciality
Code
Description
License number
State
231H00000X
Audiologist
Primary
23141
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
243537
—
OR
Enumeration date
09/25/2008
Last updated
04/19/2011
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