Shaina Marie Sullivan

NPI #1730644790 in Beaverton, Oregon

Provider Information

NPI Number: 1730644790
Entity Type: Individual
Name: Shaina Marie Sullivan
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Optometrist
Enumeration Date: Feb 4, 2019
Last Updated: Jul 19, 2019

Practice Location

Address: 12370 SW 1ST ST
City: Beaverton
State: Oregon
ZIP Code: 97005-2847
Phone: (503) 644-3614

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Optometrist	152W00000X	Primary

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