MS. MAENELL SULLIVAN


Address: 296 Sussex Ave W, Tenino, WA 98589
Phone: 3602645500

MS. MAENELL SULLIVAN (NPI# 1679675367) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1679675367
Entity Type Individual
Full Name MS. MAENELL SULLIVAN
Credential DENTURIST DPD
Practice Address 296 Sussex Ave W
Tenino
WA 98589
Mailing Address Po Box 1051
Tenino
WA 98589
Practice Telephone 3602645500
Practice Fax Number 3602645500
Mailing Telephone 3602645500
Mailing Fax Number 3602645500
Enumeration Date 2006-09-02
Last Update Date 2007-07-08
Gender Code F
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 122400000X Denturist DN361 WA Dental Providers

Other Provider Identifier

State Issuer Identifier Type Code
WA DSHS 5045273 01

Office Location

Street Address 296 SUSSEX AVE W
City TENINO
State WA
Zip Code 98589

Providers in the same location

NPI Name Taxonomy Address Enumeration
1366885204 Tenino Denture Center, LLC Denturist 296 Sussex Ave W, Tenino, WA 98589-9360 2013-04-10

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1124574413 Thurston County Fire Protection District 12 Ambulance 187 Hodgden St S, Tenino, WA 98589 2016-08-28
1902238017 Patrick Mario Williams Occupational Therapy Assistant 301 Old Highway 99 North, Tenino, WA 98589 2013-07-31
1972713527 Ronald H Coulson Chiropractor 448 Sussex Ave E, Suite 3 Box 676, Tenino, WA 98589 2007-05-23
1861533218 Jennifer L. Booker Naturopath 448 Sussex Ave East, Suite 2, Tenino, WA 98589 2007-02-09
1609979541 Tenino School District Local Education Agency (LEA) 301 Old Highway 99 N, Tenino, WA 98589 2006-09-06
1225044027 Tianne Carolyn Carrigan Massage Therapist 448 Sussex E., Suite 2, Tenino, WA 98589 2006-08-01
1831458124 Natural Wellness Pllc Chiropractor 448 Sussex Ave E, #3, Tenino, WA 98589-8703 2012-05-08
1508186214 R & D Coulson Inc. Clinic/Center 448 Sussex Ave E, 3, Tenino, WA 98589-8703 2010-06-03
1154584472 Peggy Ann Vittoria Massage Therapist 448 Sussex Ave E, #3, Tenino, WA 98589-8703 2008-07-07
1538333182 Brad E. Ellisor Chiropractor 448 Sussex Ave E, #3, Tenino, WA 98589-8703 2008-04-15
Find all providers in zip 98589

Taxonomy Information

Taxonomy Code 122400000X
Grouping Dental Providers
Classification Denturist

Taxonomy Definition

Definition to come.

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1366885204 Tenino Denture Center, LLC Denturist 296 Sussex Ave W, Tenino, WA 98589-9360 2013-04-10

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1427689421 Tri-cities Denture Studio Pllc Denturist 3909 Creekside Loop Ste 110, Yakima, WA 98902-4880 2020-01-29
1447894811 Michael Hu Denturist 430 N West Ave Ste 3, Arlington, WA 98223-1539 2019-10-29
1265999494 Sagebrush Dental LLC Denturist 1114 N Mission St Ste C, Wenatchee, WA 98801-6711 2019-02-24
1295299113 Stephanie Jean Hemenway Denturist 209 W Main Ave., Morton, WA 98356 2019-01-24
1538633664 Trang Phung Denturist 1242 State Ave Ste G, Marysville, WA 98270-3672 2019-01-11
1053884338 Juan Edward Berlanga Denturist 654 N Rochester St, Tacoma, WA 98406-1724 2019-01-09
1346713765 Cody M Dunivin Denturist 129 Valley Meadows Dr, Chehalis, WA 98532-8652 2019-01-08
1841765682 Andrew Payne Denturist 714 N Chelan Ave, Wenatchee, WA 98801-2069 2018-10-08
1154811982 Jayson Allen Laney Denturist 4001 Colby Ave Ste 2, Everett, WA 98201-6208 2018-05-17
1932697117 Jason Lee Alsbury Denturist 1715 W Kennewick Ave, Kennewick, WA 99336-3378 2018-04-24
Find all providers with the same taxonomy

Competitor

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City TENINO
Zip Code 98589

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Dataset Information

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.

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