Individual
KENT SULLIVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1530 N 115TH ST, STE 107, SEATTLE, WA 98133-8411
(206) 368-6560
(206) 368-6562
Mailing address
1530 N 115TH ST, STE 107, SEATTLE, WA 98133-8411
(206) 368-6160
(206) 368-6562
Taxonomy
Speciality
Code
Description
License number
State
207RP1001X
Pulmonary Disease Physician
Primary
MD0001591
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1100791
—
WA
01
—
P00170689
RAILROAD MEDICARE
WA
Enumeration date
06/23/2005
Last updated
08/12/2008
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