Provider Demographics
NPI:1700246808
Name:SULLIVAN HEALTH LLC
Entity Type:Organization
Organization Name:SULLIVAN HEALTH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:ASHLEY
Authorized Official - Middle Name:
Authorized Official - Last Name:SULLIVAN
Authorized Official - Suffix:
Authorized Official - Credentials:ND
Authorized Official - Phone:360-305-3665
Mailing Address - Street 1:1000 MCKENZIE AVE STE 16
Mailing Address - Street 2:
Mailing Address - City:BELLINGHAM
Mailing Address - State:WA
Mailing Address - Zip Code:98225-7003
Mailing Address - Country:US
Mailing Address - Phone:360-305-3665
Mailing Address - Fax:360-305-3665
Practice Address - Street 1:1000 MCKENZIE AVE STE 16
Practice Address - Street 2:
Practice Address - City:BELLINGHAM
Practice Address - State:WA
Practice Address - Zip Code:98225-7003
Practice Address - Country:US
Practice Address - Phone:360-305-3665
Practice Address - Fax:360-305-3665
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-03-02
Last Update Date:2016-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR1969175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes175F00000XOther Service ProvidersNaturopathGroup - Single Specialty