Individual
DR. MARCY JACKSON SULLIVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.C.
Contact information
Practice address
205 CLARK PL SE, TUMWATER, WA 98501-4062
(360) 570-0332
(360) 570-2060
Mailing address
205 CLARK PL SE, TUMWATER, WA 98501-4062
(360) 570-0332
(360) 570-2060
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
CH60030710
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0243388
LABOR AND INDUSTRIES
WA
01
—
7486SU
REGENCE
WA
Enumeration date
07/21/2008
Last updated
10/14/2010
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