MR. KEVIN DOERR SULLIVAN (NPI# 1356886998) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1356886998 |
| Entity Type | Individual |
| Full Name | MR. KEVIN DOERR SULLIVAN |
| Credential | P.A. |
| Practice Address |
208 Cedar Creek Ter Ione WA 99139-5011 |
| Practice Telephone | 5094423514 |
| Mailing Telephone | 5094423514 |
| Enumeration Date | 2017-01-05 |
| Last Update Date | 2017-02-24 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | PA60716898 | WA | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363A00000X | Physician Assistant | TA60724212 | WA | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750734992 | Kevin Sullivan | Specialist/Technologist | 936 Wynn Rd, Mcdonough, GA 30252-5802 | 2016-07-22 |
| 1457508996 | Kevin A. Sullivan | Counselor | 1500 W. Main St. Ste 300, Phoenix Counseling, Sun Prairie, WI 53590 | 2008-08-27 |
| 1770638066 | Kevin Patrick Sullivan | Dentist | 305 E 2nd Ave, Ellensburg, WA 98926-3315 | 2007-01-24 |
| 1447276225 | Kevin L. Sullivan | Radiology | 250 Ponce De Leon Ave, Suite 100, Decatur, GA 30030-3406 | 2006-07-14 |
| 1750940615 | Kevin Thomas Sullivan | Dentist | 1475 Pine Grove Rd Ste 107, Steamboat Springs, CO 80487-8851 | 2019-06-13 |
| 1275196172 | Kevin Sullivan | Behavior Technician | 1301 E Orangewood Ave, Anaheim, CA 92805-6807 | 2019-04-16 |
| 1194245662 | Kevin Brian Sullivan | Military Health Care Provider | 34800 Bob Wilson Dr, San Diego, CA 92134-1098 | 2017-06-26 |
| 1467806125 | Kevin Sullivan | Hospitalist | 12605 E 16th Ave, Aurora, CO 80045-2545 | 2016-04-19 |
| 1023479839 | Kevin Sullivan | Occupational Therapist | 5006 Copper Ave Ne, Albuquerque, NM 87108-1301 | 2016-03-08 |
| 1023478971 | Kevin Sullivan | Occupational Therapist | 7540 N 19th Ave Ste 200, Phoenix, AZ 85021-7967 | 2016-03-03 |
| Street Address |
208 CEDAR CREEK TER |
| City | IONE |
| State | WA |
| Zip Code | 99139-5011 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336352962 | Belinda Elaine Russo | Massage Therapist | 222 Sunset Dr. S., Ione, WA 99139 | 2007-05-08 |
| 1912961822 | New Health Programs Association | Clinic/Center | 208 Cedar Creek Terrace, Ione, WA 99139 | 2006-04-17 |
| 1467603266 | Joseph D Petersen | Nurse Practitioner | 208 Cedar Creek Terrace, Ione, WA 99139 | 2008-10-10 |
| 1811030323 | Richard G Calef | Physician Assistant | 208 Cedar Creek Terrace, Ione, WA 99139 | 2007-02-14 |
| 1427139583 | Joseph Sterling Taylor | Family Medicine | 208 Cedar Creek Terrace, Box 197, Ione, WA 99139 | 2006-10-17 |
| 1659479723 | Shirley G Wagoner | Nurse Practitioner | 208 Cedar Creek Terrace, Ione, WA 99139-0197 | 2006-09-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861032286 | Emily Campbell | Doula | 3454 Flint Trl, Ione, CA 95640-9679 | 2020-01-14 |
| 1982185476 | Carol Sundell | Licensed Vocational Nurse | 325 S Sacramento St, Ione, CA 95640-9172 | 2018-08-23 |
| 1316423692 | Millie Georganna Herrera | Psychologist | 4001 State Higheay 104, Ione, CA 95640 | 2018-07-19 |
| 1861932378 | Dawn Kettell-ness | Registered Nurse | 2000 Camanche Rd Spc 54, Ione, CA 95640-9427 | 2017-03-02 |
| 1952750663 | Deborah Jo Smith | Marriage & Family Therapist | 1400 W Marlette St Spc 17, Ione, CA 95640-9517 | 2016-06-03 |
| 1033578968 | Hector Duran Flores | Non-emergency Medical Transport (VAN) | 3495 Lakeview Dr, Ione, CA 95640-9613 | 2016-02-20 |
| 1134598295 | O. M. Custer | Psychologist | 14 West Main St, Suite 5, Ione, CA 95640-1415 | 2015-09-18 |
| 1538542832 | Wendy Sober | Marriage & Family Therapist | 813 Dove Ln, Ione, CA 95640-9203 | 2015-07-06 |
| 1477945517 | Morrow County Health District | Clinic/Center | 365 W 3rd St, Ione, OR 97843-7216 | 2015-02-26 |
| 1164810370 | Sarah D Smith | Psychologist | 4001 Highway-104, Ione, CA 95640 | 2014-12-23 |
| Find all providers in IONE | ||||
| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518133693 | Christian Alexander Carter | Physician Assistant | 200 Covey Ct, Ione, CA 95640-5226 | 2008-05-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831790591 | Bailey Mantha-nagrant | Physician Assistant | 7912 170th Ave Ne Unit 301, Redmond, WA 98052-0907 | 2020-11-07 |
| 1518567791 | Addison Christine Richert | Physician Assistant | 121 Kingfisher Pl, Port Hadlock, WA 98339-8733 | 2020-10-28 |
| 1992312177 | Robert Monsees | Physician Assistant | 490 Packwood Ln, Ellensburg, WA 98926-8027 | 2020-09-30 |
| 1649887548 | Jesse E Davis | Physician Assistant | 3512 Serene Way, Lynnwood, WA 98087-5202 | 2020-09-25 |
| 1558977066 | Kimberly Ho | Physician Assistant | 23004 88th Ave W, Edmonds, WA 98026-8616 | 2020-09-20 |
| 1770198954 | Ashish Chaudhary | Physician Assistant | 1215 Dexter Ave N Apt 704, Seattle, WA 98109-3567 | 2020-09-14 |
| 1144835422 | Juleeann Stocking | Physician Assistant | 1517 17th Ave S, Seattle, WA 98144-3522 | 2020-09-13 |
| 1891309555 | Andrew Allyn Bloom | Physician Assistant | 5889 Bow St, Bow, WA 98232-8620 | 2020-09-01 |
| 1558973909 | Margaret Webster | Physician Assistant | 6501 36th Ave Nw, Seattle, WA 98117-6010 | 2020-08-18 |
| 1033720495 | Riley Richardson | Physician Assistant | 1008 E Windemere Ct, Spokane, WA 99223-6228 | 2020-08-11 |
| Find all providers with the same taxonomy | ||||
Please comment or provide details below to improve the information on MR. KEVIN DOERR SULLIVAN.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.