1. Home
  2. Directory
  3. Oregon
  4. Salem
  5. Licensed Practical Nurse
  6. NPI Profile

SAMUEL SULLIVAN
NPI 1730775495
Licensed Practical Nurse in Salem, OR

Active since December 16, 2020
1750 MCGILCHRIST ST SE STE 130, SALEM, OR 97302(971) 304-2200 Get Directions Write a Review

NPPES record last updated: December 16, 2020. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Samuel Sullivan NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SAMUEL SULLIVAN (NPI 1730775495) is an individual licensed practical nurse in Salem, Oregon, licensed in Oregon (202007792LPN) and active in the NPI registry since December 2020.

NPPES Registry Identity

NPI1730775495
Entity TypeIndividualMale
Primary Taxonomy164W00000X
Provider Legal NameSAMUEL SULLIVAN
Location Address1750 MCGILCHRIST ST SE STE 130Salem, OR 97302-1691
Mailing Address1332 Lydia Ave NKeizer, OR 97303-7550 · (516) 860-7294
Phone(971) 304-2200
Sole ProprietorNo
Enumeration DateDecember 16, 2020
NPPES CertifiedDecember 16, 2020
✔ NPI 1730775495 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyLicensed Practical NurseNursing Service Providers
Taxonomy Code164W00000X
License✔ Licensed in OR · 202007792LPN
Definition
A licensed practical nurse with post-high school vocational training and practical experience in the provision of nursing care at a level less than that required for certification as a Registered Nurse. Requirements for education, experience, licensure, and job responsibilities vary among the states.
1750 MCGILCHRIST ST SE STE 130, Salem, OR 97302
Open in Google Maps ↗

Other Providers at the Same Location NPPES 11

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

KRISTIE LYN BROCK PTA
Physical Medicine & Rehabilitation
1750 MCGILCHRIST ST SE STE 130
SALEM, OR 97302
Marion County (971) 304-2200
JORDAN SKOUBO RD, MPH, CPH
Dietitian, Registered
1750 MCGILCHRIST ST SE STE 130
SALEM, OR 97302
Marion County (971) 304-2200
DR. JOHN ROBERT WALTERS MD
Family Medicine
1750 MCGILCHRIST ST SE STE 130
SALEM, OR 97302
Marion County (971) 304-2200
MELISSA Q CHEN OD
Optometrist
1750 MCGILCHRIST ST SE STE 130
SALEM, OR 97302
Marion County (971) 304-2200
AMBER BUI OD
Student in an Organized Health Care Education/Training Program
1750 MCGILCHRIST ST SE STE 130
SALEM, OR 97302
Marion County (971) 304-2210
ANNIE M REYNOLDS DNP
Nurse Practitioner (Family)
1750 MCGILCHRIST ST SE STE 130
SALEM, OR 97302
Marion County (971) 304-2200
ADELHEID M ALLEN
Registered Nurse
1750 MCGILCHRIST ST SE STE 130
SALEM, OR 97302
Marion County (971) 304-2200
MS. LETITIA CECELIA ADAMS
Technician/Technologist (Ophthalmic)
1750 MCGILCHRIST ST SE STE 130
SALEM, OR 97302
Marion County (503) 721-1499

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 Samuel Sullivan's NPI number?

The NPI number for Samuel Sullivan is 1730775495. It was assigned to this individual provider in the NPPES registry on December 16, 2020.

Where is Samuel Sullivan located?

Samuel Sullivan practices at 1750 Mcgilchrist St SE Ste 130, Salem, OR 97302. The listed phone number is (971) 304-2200.

What is Samuel Sullivan's specialty?

The primary specialty registered for this NPI is Licensed Practical Nurse with taxonomy code 164W00000X.

When was this NPI record last updated?

The NPPES record for Samuel Sullivan was last updated on December 16, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.