Organization
NORTHWEST HOSPITAL PROVIDER TRUST
Active
Other names
Kent Sullivan, MD
Organization subpart
No
Provider details
NPI number
Authorized official
MS. KRISTI HAMLET (CLINIC MANAGER)
(206) 368-6572
Entity
Organization
Contact information
Practice address
1530 N 115TH ST, SUITE 107, SEATTLE, WA 98133-8421
(206) 368-6560
(206) 368-6562
Mailing address
1530 N 115TH ST, SUITE107, SEATTLE, WA 98133-8421
(206) 368-6560
(206) 368-6562
Taxonomy
Speciality
Code
Description
License number
State
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
DB5811
RAILROAD MEDICARE
WA
Enumeration date
04/06/2006
Last updated
11/06/2007
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