Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | MT192880 | PA |
Y | 2080P0202X | Pediatric Cardiologist | MD60215606 | WA |
NPI | 1174789523 |
---|---|
Provider Name | Patrick Morris Sullivan |
First Address | Seattle, WA 98105-3901 |
Second Address | Seattle, WA 98105-3901 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/08/2008 |
Last Update Date | 11/06/2014 |