Shannon Elyse Sullivan, OTR/L

Primary specialty

Pediatric Occupational TherapistTaxonomy code 225XP0200X

License

60896414 Issued in WA

Practice address

14715 NE Bel Red Rd
Bellevue, WA 98007-3940

Phone

(425) 502-9440

NPI assigned

Oct 8, 2018

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": "1538956800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1538956800000",
    "number": "1679048425",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2233 NE 46TH ST APT 202",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981055736",
            "telephone_number": "785-418-9810"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14715 NE BEL RED RD",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980073940",
            "telephone_number": "425-502-9440"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SULLIVAN",
        "first_name": "SHANNON",
        "middle_name": "ELYSE",
        "credential": "OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-10-08",
        "last_updated": "2018-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XP0200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "WA",
            "license": "60896414",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Karen D Sullivan-Kniestedt, PT
• Adam Sullivan
• Kaitlin Elizabeth Sullivan, OTR/L
• Richard Michael Sullivan, PTA
• Roisin Sullivan
• Thomas P Sullivan, M.D.
• Sum of Learning, LLC
• Rosanne Sumalpong
• Summit BHC Seattle LLC
• Summit Healthcare Alliance PLLC

• Pediatric Occupational Therapist in Bellevue, WA
• Providers in Bellevue, WA by specialty
• Pediatric Occupational Therapist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 2018; 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.