Provider Demographics
NPI:1154130466
Name:SULLIVAN, TATIANA (MEDICAL INTERPRETER)
Entity type:Individual
Prefix:
First Name:TATIANA
Middle Name:
Last Name:SULLIVAN
Suffix:
Gender:F
Credentials:MEDICAL INTERPRETER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5924 BAYNEBRIDGE DR
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23464-1572
Mailing Address - Country:US
Mailing Address - Phone:509-954-2674
Mailing Address - Fax:
Practice Address - Street 1:5924 BAYNEBRIDGE DR
Practice Address - Street 2:
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23464-1572
Practice Address - Country:US
Practice Address - Phone:509-954-2674
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-01-01
Last Update Date:2025-01-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA14821171R00000X
WA2176171R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171R00000XOther Service ProvidersInterpreter