Provider Demographics
NPI:1265729354
Name:SULLIVAN, WILLIAM EUGENE (OD)
Entity type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:EUGENE
Last Name:SULLIVAN
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:BILL
Other - Middle Name:
Other - Last Name:SULLIVAN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:OD
Mailing Address - Street 1:2715 W COURT ST
Mailing Address - Street 2:
Mailing Address - City:PASCO
Mailing Address - State:WA
Mailing Address - Zip Code:99301-3911
Mailing Address - Country:US
Mailing Address - Phone:509-547-8409
Mailing Address - Fax:
Practice Address - Street 1:2715 W COURT ST
Practice Address - Street 2:
Practice Address - City:PASCO
Practice Address - State:WA
Practice Address - Zip Code:99301-3911
Practice Address - Country:US
Practice Address - Phone:509-547-8409
Practice Address - Fax:509-544-7875
Is Sole Proprietor?:No
Enumeration Date:2011-07-09
Last Update Date:2025-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAOD60233648152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist