NPI 1063822104

Piper H Sullivan, PAC

Practitioner Physician Assistant Sherwood, OR

Practice location

Address: 16770 SW Edy Rd STE 102, Sherwood, OR 97140-9679
Phone: (503) 216-9600
Mailing address: PO Box 3158, Portland, OR 97208-3158

Registered specialties

Physician Assistant Primary

Physician Assistants & Advanced Practice Nursing Providers Taxonomy 363A00000X Licence PA171929 (OR)

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Registry record

NPI: 1063822104
Entity type: Individual
Sex (as registered): Female
NPI issued: 29 Apr 2014
Record last updated: 26 Apr 2023

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.