Micah Sullivan | Seattle, WA • PECOS Search

Micah Sullivan

Counselor

Behavioral Health & Social Service Providers

929 N 130th St Ste 3, Seattle, WA 98133-7500

PECOS Enrollment

Based on the most recent information from CMS, provider Micah Sullivan does not have current enrollment records in PECOS.

Part B
Medicare Part B
Not Enrolled
HHA
Home Health Agency
Not Enrolled
DME
Durable Medical Equipment
Not Enrolled
PMD
Power Mobility Device
Not Enrolled

CMS last updated its PECOS records 12 days ago.

Profile Details

Provider ID
1316612815
Provider Type
Individual
Full Name
Sullivan, Micah
Gender
Male

Sole Proprietor
No
Enumeration Date
8/16/2021
Last Updated
8/16/2021

Contact Information

Practice Location

929 N 130th St Ste 3, Seattle, WA 98133-7500

Unlisted Fax

Mailing Location

325 W Gowe St, Kent, WA 98032-5892

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 101Y00000X Primary	Description Counselor Behavioral Health & Social Service Providers	License Unlisted Issuer Washington