GEORGE BLAKE SULLIVAN (NPI# 1225671720) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1225671720 |
| Entity Type | Individual |
| Full Name | GEORGE BLAKE SULLIVAN |
| Practice Address |
400 Warren Ave Ste 200 Bremerton WA 98337-1467 |
| Mailing Address |
16310 Reitan Rd Ne Bainbridge Island WA 98110-3047 |
| Practice Telephone | 3603773776 |
| Enumeration Date | 2019-10-28 |
| Last Update Date | 2019-10-28 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LP2300X |
Nurse Practitioner Specialization: Primary Care |
AP61014314 | WA | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144358557 | George Sullivan | Specialist | 1506 5th Ave Sw, Olympia, WA 98502-5248 | 2007-02-28 |
| 1225552052 | George Sullivan | Assistant Behavior Analyst | 312 Marshall Ave Ste 102, Laurel, MD 20707-4840 | 2017-08-02 |
| 1447237813 | George Sullivan | Anesthesiology | 601 E Rollins St, Orlando, FL 32803-1248 | 2005-12-28 |
| Street Address |
400 WARREN AVE STE 200 |
| City | BREMERTON |
| State | WA |
| Zip Code | 98337-1467 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699142885 | Justin Thomas Eckert | Physician Assistant | 400 Warren Ave Ste 200, Bremerton, WA 98337-1467 | 2015-08-24 |
| 1811505316 | Amelia Finney | Social Worker | 400 Warren Ave Ste 200, Bremerton, WA 98337-1467 | 2020-07-21 |
| 1225653603 | Judy Wambui Njoki | Counselor | 400 Warren Ave Ste 200, Bremerton, WA 98337-1467 | 2020-06-11 |
| 1093356982 | Ramona Y Arne | Counselor | 400 Warren Ave Ste 200, Bremerton, WA 98337-1467 | 2019-10-02 |
| 1386125565 | Adam David Boyd | Physician Assistant | 400 Warren Ave Ste 200, Bremerton, WA 98337-1467 | 2018-08-24 |
| 1245740612 | Billie Jo St Jean | Counselor | 400 Warren Ave Ste 200, Bremerton, WA 98337-1467 | 2017-10-11 |
| 1326566928 | Leah Rae Boyd | Physician Assistant | 400 Warren Ave Ste 200, Bremerton, WA 98337-1467 | 2017-09-03 |
| 1356700322 | Peninsula Community Health Services | Clinic/Center | 400 Warren Ave Ste 200, Bremerton, WA 98337-1467 | 2016-02-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902379563 | Paul Hastings | Physician Assistant | Peninsula Community Health Services, 400 Warren Ave, Suite 200, Bremerton, WA 98337 | 2019-01-07 |
| 1083199285 | Jacob Lawrence Barnes | Behavioral Analyst | 1709 13th St, Bremerton, WA 98337 | 2018-10-03 |
| 1295254092 | James Richard Mccormack | Counselor | 851 6th St Ste 135, Kitsap Hypnosis Center LLC, Bremerton, WA 98337 | 2017-09-12 |
| 1629593728 | Tina Mae Davis-munn | Registered Nurse | 345 6th St, Suite 300, Bremerton, WA 98337 | 2017-08-09 |
| 1962927384 | Linda Louise Tourigny | Registered Nurse | 345 6th St Suite 300, Bremerton, WA 98337 | 2017-08-07 |
| 1417480609 | Diane Marie Sabo | Counselor | 843 6th Street, Suite 220 and 240, Bremerton, WA 98337 | 2017-04-05 |
| 1659792265 | Allan L Hablutzel | Dentist | 820 Pacific Ave., Suite 204, Bremerton, WA 98337 | 2013-12-27 |
| 1881979722 | Sidestix Ventures Usa | Durable Medical Equipment & Medical Supplies | 410 Ida St. West, Ste 201, Bremerton, WA 98337 | 2011-10-11 |
| 1346545829 | Doyle & Associates Chiropractic Clinic Inc Ps | Chiropractor | 603 Chester Avenue, Bremerton, WA 98337 | 2011-01-14 |
| 1285762856 | Tracee Arlene Costa | Massage Therapist | 911 Adele Rd., Bremerton, WA 98337 | 2007-03-02 |
| Find all providers in zip 98337 | ||||
| Taxonomy Code | 363LP2300X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Primary Care |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841802675 | Michelle Ann Rorie | Nurse Practitioner | 1100 Villanova St Ne, Olympia, WA 98516-5454 | 2020-08-22 |
| 1174132294 | Heather Catherine Pounds | Nurse Practitioner | 4222 Robin Rd W, University Place, WA 98466-1536 | 2020-07-24 |
| 1801410675 | Mi Thi Trieu Tran | Nurse Practitioner | 24611 116th Ave Se, Kent, WA 98030-4939 | 2020-06-08 |
| 1609409085 | Kris Dee Chatman | Nurse Practitioner | 1628 S Mildred St Ste 105, Tacoma, WA 98465-1628 | 2020-02-13 |
| 1912547365 | Thomas Lee Etherton | Nurse Practitioner | 4425 Cole Ct Se, Olympia, WA 98501-4474 | 2020-01-14 |
| 1306489760 | Nikolaus V Voswinkel | Nurse Practitioner | 1420 Terry Ave Unit 202, Seattle, WA 98101-1981 | 2019-10-17 |
| 1518509520 | Sasha Rose Jensen | Nurse Practitioner | 460 West G Street, Forks, WA 98331 | 2019-10-10 |
| 1306487772 | Harmony Kroll | Nurse Practitioner | 23475 225th Way Se, Ste 201, Maple Valley, WA 98038-5294 | 2019-10-07 |
| 1932751658 | Lesly Marie Dosono Barcena | Nurse Practitioner | 6700 Roosevelt Way Ne Apt A211, Seattle, WA 98115-6642 | 2019-07-12 |
| 1912568205 | Andrea Lyn Fellman | Nurse Practitioner | Ideal Option Clinic 328 South Stillaguamish Ave, Arlington, WA 98223-1660 | 2019-06-26 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.