Active NPI
Stephen D Sullivan, RN
- Critical Care Medicine Registered Nurse
- Tacoma, WA
National Provider Identifier
1063208593
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Critical Care Medicine Registered Nurse
- License
- RN60082129
- Practice address
- 1717 S J St
Tacoma, WA 98405-4933 - Phone
- (253) 426-4100
- NPI assigned
- Apr 21, 2025
- Sex
- Unspecified or another gender identity
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Critical Care Medicine Registered Nurse | 163WC0200X | RN60082129 | WA | Primary |
Addresses
Primary practice location
1717 S J St
Tacoma, WA 98405-4933
Mailing address
814 Eastside St NE # Be
Olympia, WA 98506-4032
Phone (360) 319-6359
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RN60082129 | WA | MD | Critical Care Medicine Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1745193600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1745193600000",
"number": "1063208593",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "814 EASTSIDE ST NE # BE",
"city": "OLYMPIA",
"state": "WA",
"postal_code": "985064032",
"telephone_number": "360-319-6359"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1717 S J ST",
"city": "TACOMA",
"state": "WA",
"postal_code": "984054933",
"telephone_number": "253-426-4100"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SULLIVAN",
"first_name": "STEPHEN",
"middle_name": "D",
"name_prefix": "Mr.",
"credential": "RN",
"sole_proprietor": "NO",
"sex": "X",
"enumeration_date": "2025-04-21",
"last_updated": "2025-04-21",
"certification_date": "2025-04-20",
"status": "A"
},
"taxonomies": [
{
"code": "163WC0200X",
"taxonomy_group": "",
"desc": "Registered Nurse, Critical Care Medicine",
"state": "WA",
"license": "RN60082129",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Tacoma, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.