Sullivan, Zachary Adam

Sullivan, Zachary Adam is an individual health care provider with primary practice located at 9230 Sky Island Dr E , Bonney Lake WA 98391-7385. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as his primary health care specialty. Sullivan, Zachary Adam can be contacted via phone (253) 750-6000.

Contact Information

Primary practice address
9230 Sky Island Dr E Bonney Lake WA 98391-7385
Phone: (253) 750-6000
Fax: (253) 627-7880
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X PA60831973 Washington

Profile Details

NPI number 1467950782
LBN Legal business name Sullivan, Zachary Adam
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 1st, 2018
Last updated Jan 18th, 2021 - about 4 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1467950782 NPPES
Washington MEDICAID 2097333

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