Doctor Name: | DR. RACHEL M. SULLIVAN |
NPI Number: | 1750543294 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | M.D. |
License Number: | 25421 |
Business Practice Address: | Madigan Army Medical Ctr Attn: Mchj-clq-c, Room 1-92-5, 9040a Reid Street Tacoma, WA - 984311100 |
Business Phone Number: | 2539683869 |
Business Fax Number: | |
Mailing Address: | Madigan Army Medical Ctr, Attn: Mchj-clq-c, Room 1-92-5, 9040a Reid Street TACOMA |
State: | WA |
Postal Code: | 984311100 |
Phone Number: | 2539683869 |
Fax Number: | |
NPI Enumeration Date: | 06/26/2008 |
NPI Last Update Date: | 10/07/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | 25421 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | NE |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |