MEDICARE: AMBER SULLIVAN ND, LAC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	171100000X	Acupuncturist	AC00002987	WA
2	175F00000X	Naturopath	NT60886784	WA

General Provider Information

NPI Number	:	1235371592
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AMBER SULLIVAN ND, LAC.

Provider Business Mailing Address
First Line	:	1600 E JEFFERSON ST STE 603
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98122-5649
Country	:	US
Telephone Number	:	206-726-0034
Fax Number	:	206-726-9434

Provider Business Practice Location Address
First Line	:	1600 E JEFFERSON ST STE 603
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98122
Country	:	US
Telephone Number	:	206-726-0034
Fax Number	:	206-726-9434

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/01/2009
Last Update Date	:	03/13/2026

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