Individual
MR. JOSEPH ANDREW SULLIVAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
B.S
Contact information
Practice address
1500 NE IRVING ST, PORTLAND, OR 97232-2243
(503) 258-4200
Mailing address
12042 SE REGAL CT, CLACKAMAS, OR 97015-9245
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
08/15/2010
Last updated
08/15/2010
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