JACK SULLIVAN MD
NPI 1174325211
Student in an Organized Health Care Education/Training Program in Seattle, WA
About Jack Sullivan Md NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
JACK SULLIVAN MD (NPI 1174325211) is an individual student in an organized health care education/training program in Seattle, Washington and active in the NPI registry since March 2025. He is enrolled in Medicare PECOS.
NPPES Registry Identity
Specialties & Licenses
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Jack Sullivan Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Other Providers at the Same Location NPPES 20
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
SEATTLE, WA 98122
SEATTLE, WA 98122
SEATTLE, WA 98122
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Jack Sullivan's NPI number?
The NPI number for Jack Sullivan is 1174325211. It was assigned to this individual provider in the NPPES registry on March 27, 2025.
Where is Jack Sullivan located?
Jack Sullivan practices at 550 16th Ave Ste 100, Seattle, WA 98122. The listed phone number is (120) 632-0248.
What is Jack Sullivan's specialty?
The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.
Is Jack Sullivan enrolled in Medicare?
Yes. Jack Sullivan is registered in the Medicare PECOS enrollment system.
When was this NPI record last updated?
The NPPES record for Jack Sullivan was last updated on March 27, 2025. NPI Profile syncs with the weekly NPPES data releases published by CMS.
