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General NPI Number Information
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NPI Number | 1083967566
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Entity Type | Individual
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Provider Name | THOMAS CHRISTOPHER SULLIVAN D.V.M.
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Gender | Male
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Dates
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Enumeration Date | 10/20/2012
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Last Update Date | 10/20/2012
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Provider Practice Location Address
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Address Line | 5339 ROOSEVELT WAY NE
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City | SEATTLE
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State | WA
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Zip | 98105-3635
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Country | US
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Telephone | 206-524-8822
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Fax | 206-524-3551
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Provider Business Mailing Address
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Address Line | 5339 ROOSEVELT WAY NE
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City | SEATTLE
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State | WA
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Zip | 98105-3635
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Country | US
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Telephone | 206-524-8822
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Fax | 206-524-3551
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | VT00004977
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License Number State | WA
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