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1306852801
FRED RICHARD SULLIVAN
PORTLAND, OR
NPI
1306852801
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
207RH0000X Internal Medicine, Hematology
(Licence: OR MD24620)
Enumeration Date
2006-08-01
Last Update Date
2007-07-16
Business Address
Dr. FRED RICHARD SULLIVAN MD
3181 SW SAM JACKSON PARK RD
PORTLAND, OR 97239-3011
Phone number: 503-494-6594
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Mailing Address
Dr. FRED RICHARD SULLIVAN MD
3181 SW SAM JACKSON PARK RD
PORTLAND, OR 97239-3011
Phone number:
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