Sullivan, Brian W
Sullivan, Brian W is an individual health care provider with primary practice located at 215 Lilly Rd Ne , Olympia WA 98506-5030. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Sullivan, Brian W can be contacted via phone (360) 456-4800.Contact Information
Primary practice address
215 Lilly Rd Ne
Olympia WA 98506-5030
Phone: (360) 456-4800
Fax: (360) 456-4812
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Eye and Vision Services Providers / Optometrist | 152W00000X | OD00001680 | Washington |
Profile Details
| NPI number | 1184787988 |
|---|---|
| LBN Legal business name | Sullivan, Brian W |
| Credentials | Doctor of Optometry (OD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Dec 19th, 2006 |
| Last updated | Jul 8th, 2007 - about 18 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1184787988 | NPPES |
| Washington | MEDICAID | 2011971 |
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