Douglas E Sullivan, DC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

CH00034393 Issued in WA

Practice address

304 Main Ave S
203
Renton, WA 98057-2758

Phone

(206) 683-2995

Fax

(206) 666-6213

NPI assigned

Apr 25, 2007

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Douglas Sullivan, PC

  • Chiropractor
  • Renton, WA
  • NPI 1609109669
  NPD (past) Authorized official
• Ashley Antonoff, P.S.

  • Chiropractor
  • Bellevue, WA
  • NPI 1821008103
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1177459200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1252454400000",
    "number": "1104045137",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "304 MAIN AVE S",
            "address_2": "203",
            "city": "RENTON",
            "state": "WA",
            "postal_code": "980572758",
            "telephone_number": "206-683-2995",
            "fax_number": "206-666-6213"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "304 MAIN AVE S",
            "address_2": "203",
            "city": "RENTON",
            "state": "WA",
            "postal_code": "980572758",
            "telephone_number": "206-683-2995",
            "fax_number": "206-666-6213"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SULLIVAN",
        "first_name": "DOUGLAS",
        "middle_name": "E",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-25",
        "last_updated": "2009-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "WA",
            "license": "CH00034393",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Hong L Styskal, OT
• Dennis Lien-Hsun Su, M.D.
• Chanyoung David Suh, DMD
• Shaila Suleman
• Arthur Francis Sullivan IV, M.D.
• Ali Sultan-Qurraie, M.D.
• Steven L Summerfield, MD
• Aristotle Sun, MD, MPH
• Jianping Sun, MD
• Minatsu Sunagawa

• Chiropractor in Renton, WA
• Providers in Renton, WA by specialty
• Chiropractor in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.