Active NPI
Polly A Sullivan, RC
- Social Worker
- Seattle, WA
National Provider Identifier
1942476007
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- RC00016759
- Practice address
- 550 17TH Ave
5TH Floor
Seattle, WA 98122-5788 - Phone
- (206) 386-3880
- Fax
- (206) 386-3882
- NPI assigned
- May 7, 2008
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Social Worker | 104100000X | RC00016759 | WA | Primary |
Addresses
Primary practice location
550 17TH Ave
5TH Floor
Seattle, WA 98122-5788
Mailing address
PO Box 84026
Seattle, WA 98124-8426
Phone (206) 386-3880
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RC00016759 | WA | MD | Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1210118400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1234915200000",
"number": "1942476007",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 84026",
"city": "SEATTLE",
"state": "WA",
"postal_code": "981248426",
"telephone_number": "206-386-3880",
"fax_number": "206-386-3882"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "550 17TH AVE",
"address_2": "5TH FLOOR",
"city": "SEATTLE",
"state": "WA",
"postal_code": "981225788",
"telephone_number": "206-386-3880",
"fax_number": "206-386-3882"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SULLIVAN",
"first_name": "POLLY",
"middle_name": "A",
"name_prefix": "Ms.",
"credential": "RC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-05-07",
"last_updated": "2009-02-18",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "WA",
"license": "RC00016759",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Seattle, WA
- Michael Augustus Sullivan
- Michele Marie Sullivan, M.S., LMFT, CMHS
- Miranda Rosemarie Sullivan, LICSW, MHP, SUDPT
- Norah Mary Sullivan, ARNP
- Patrick Morris Sullivan, M.D.
- Sara Zoeann Sullivan, PT
- Scott Jeffrey Sullivan, DDS
- Sean D. Sullivan, PHARMD
- Shawna Sullivan, MSW, LICSW
- Tara Marie Sullivan, D.D.S.
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 18, 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.