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General NPI Number Information
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NPI Number | 1619409497
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Entity Type | Individual
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Provider Name | MICHAEL SUN
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Gender | Male
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Dates
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Enumeration Date | 03/30/2017
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Last Update Date | 05/06/2024
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Provider Practice Location Address
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Address Line | 5440 LEARY AVE NW
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City | SEATTLE
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State | WA
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Zip | 98107-4072
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Country | US
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Telephone | 917-794-2781
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Fax |
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Provider Business Mailing Address
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Address Line | 5440 LEARY AVE NW
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City | SEATTLE
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State | WA
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Zip | 98107-4072
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Country | US
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Telephone | 917-794-2781
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Fax |
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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 | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 314014
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 283150
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License Number State | MA
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