Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Samuel Sullivan

Individual provider Licensed Practical Nurse · NPI 1730775495

Samuel Sullivan is a Licensed Practical Nurse in Salem, Oregon. Licensed in Oregon. Registered with an NPI since 2020.

Licensed in
OR
In the registry since
2020

Practice location Address checks out

1750 McGilchrist St SE Ste 130
Salem, OR 97302-1691
Phone: (971) 304-2200
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Licensed Practical Nurse (primary) Taxonomy 164W00000X · Licence 202007792LPN (OR)

Record details

NPI number1730775495
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedDecember 16, 2020
Last updated in NPPESDecember 16, 2020
Certification dateDecember 16, 2020
Mailing address1332 Lydia Ave N, Keizer, OR 97303-7550

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