Sydney Sullivan, OTR/L

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

61391264 Issued in WA

Practice address

4201 NE 66TH Ave Ste 106
Vancouver, WA 98661-3078

Phone

(360) 885-4684

Fax

(360) 882-8972

NPI assigned

Apr 27, 2023

Sex

Female

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)

Not enrolled

State licenses

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

{
    "created_epoch": "1682553600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1682553600000",
    "number": "1619665536",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4201 NE 66TH AVE STE 106",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986613078",
            "telephone_number": "360-885-4684",
            "fax_number": "360-882-8972"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4201 NE 66TH AVE STE 106",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986613078",
            "telephone_number": "360-885-4684",
            "fax_number": "360-882-8972"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SULLIVAN",
        "first_name": "SYDNEY",
        "credential": "OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-04-27",
        "last_updated": "2023-04-27",
        "certification_date": "2023-04-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "WA",
            "license": "61391264",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Namsoo Suh, M.D.
• Carolyn Sui, MD
• Chulachak Jon Sukachevin, M.D.
• Yana O Sulakov
• Elizabeth Sullivan
• Veronica N Sullivan, PH.D.
• Stephanie Sulman, LICSW
• Bruce Summerhill
• Mary Frances Summers, RN,
• Jeffery Summerville II

• Occupational Therapist in Vancouver, WA
• Providers in Vancouver, WA by specialty
• Occupational Therapist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 27, 2023; 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.