Paul B Sullivan, CRNA is a
Nurse Anesthetist, Certified Registered based in Colfax, Washington. Paul B Sullivan is licensed to practice in Washington (license number AP30005473) and his current practice location is
1200 W Fairview St, Colfax, Washington. He can be reached at his office (for appointments etc.) via phone at
(509) 926-1770.
NPI number for Paul B Sullivan is 1023128451 and his current mailing address is 21980 E Country Vista Dr, Ste 200, Liberty Lake, Washington. He
does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1023128451.
Provider's Profile
| Full Name | Paul B Sullivan |
|---|
| Gender | Male |
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| Speciality | Nurse Anesthetist, Certified Registered |
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| Location | 1200 W Fairview St, Colfax, Washington |
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| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
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NPI Data:
- NPI Number: 1023128451
- Provider Enumeration Date: 08/30/2006
- Last Update Date: 11/08/2016
Medical Identifiers
Medical identifiers for Paul B Sullivan such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1023128451 | NPI | - | NPPES |
| 9617499 | Medicaid | WA | |
| 912153623 | Other | WA | TAX ID |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 367500000X | Nurse Anesthetist, Certified Registered | AP30005473 (Washington) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Paul B Sullivan is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Paul B Sullivan, CRNA
21980 E Country Vista Dr, Ste 200,
Liberty Lake, WA 99019-6025
Ph: (509) 926-1770 | Paul B Sullivan, CRNA
1200 W Fairview St,
Colfax, WA 99111-9552
Ph: (509) 926-1770 |
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