NPI 1073820437

Nina Noella Sullivan, LMT

Practitioner Contractor Eugene, OR

Practice location

Address: 2746 Shadow View Dr, Eugene, OR 97408-4610
Phone: (541) 345-0551
Mailing address: 6653 Jacob Ln, Springfield, OR 97478-2110

Registered specialties

Contractor Primary

Other Service Providers Taxonomy 171W00000X Licence 3320 (OR)

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Registry record

NPI: 1073820437
Entity type: Individual
Sex (as registered): Female
NPI issued: 7 Sep 2010
Record last updated: 7 Sep 2010

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.