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Contact Information

COLLEEN A OSULLIVAN, PA
1253 NW CANAL BLVD
REDMOND, OR97708
 Phone: 541-548-8131
 Fax: 541-460-4028
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Physician Assistant

363A00000X 97 Physician Assistant
Indicates primary specialty

NPI Profile & details for COLLEEN A OSULLIVAN · (Female)

NPI # 1427051713
Status Active
Credentials PA (Physician Assistant)
Entity Individual
Enumeration date 05/31/2005
Last updated 12/26/2014 - About 11 years ago
Sole proprietor 1 No
Identifiers
  • CA License # PA20422
  • OR License # 169425
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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