Kent N Sullivan MD PLLC

Primary specialty

Pulmonary Disease PhysicianTaxonomy code 207RP1001X

License

MD0001591 Issued in WA

Legal business name

KENT N SULLIVAN MD PLLC

Practice address

19219 51St Ave NE
Lake Forest Park, WA 98155-2940

Phone

(206) 406-5723

Fax

(206) 527-0147

NPI assigned

Feb 29, 2016

Last updated

Feb 29, 2016By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Kent N Sullivan, MD

Title

Physician Owner

Phone

(206) 406-5723

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1456704000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1456704000000",
    "number": "1386004638",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19219 51ST AVE NE",
            "city": "LAKE FOREST PARK",
            "state": "WA",
            "postal_code": "981552940",
            "telephone_number": "206-406-5723",
            "fax_number": "206-527-0147"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19219 51ST AVE NE",
            "city": "LAKE FOREST PARK",
            "state": "WA",
            "postal_code": "981552940",
            "telephone_number": "206-406-5723",
            "fax_number": "206-527-0147"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KENT N SULLIVAN MD PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-02-29",
        "last_updated": "2016-02-29",
        "status": "A",
        "authorized_official_last_name": "SULLIVAN",
        "authorized_official_first_name": "KENT",
        "authorized_official_middle_name": "N",
        "authorized_official_title_or_position": "PHYSICIAN OWNER",
        "authorized_official_telephone_number": "206-406-5723",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "WA",
            "license": "MD0001591",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Pulmonary Disease Physician in Lake Forest Park, WA
• Providers in Lake Forest Park, WA by specialty
• Pulmonary Disease Physician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 29, 2016; 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.