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1225671720
GEORGE BLAKE SULLIVAN
BREMERTON, WA
NPI
1225671720
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
363LP2300X Nurse Practitioner Primary Care
(Licence: WA AP61014314)
Enumeration Date
2019-10-28
Last Update Date
2019-10-28
Business Address
GEORGE BLAKE SULLIVAN
400 WARREN AVE STE 200
BREMERTON, WA 98337-1467
Phone number: 360-377-3776
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Mailing Address
GEORGE BLAKE SULLIVAN
16310 REITAN RD NE
BAINBRIDGE ISLAND, WA 98110-3047
Phone number:
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