Basic Information
Provider Information
NPI: 1700185832
EntityType: 2
ReplacementNPI:  
OrganizationName: SUNRISE SERVICES INC.
LastName:  
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MiddleName:  
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Credential:  
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Mailing Information
Address1: PO BOX 2569
Address2:  
City: EVERETT
State: WA
PostalCode: 982130569
CountryCode: US
TelephoneNumber: 4252124200
FaxNumber:  
Practice Location
Address1: 7003 EVERGREEN WAY
Address2:  
City: EVERETT
State: WA
PostalCode: 982035153
CountryCode: US
TelephoneNumber: 4252124200
FaxNumber:  
Other Information
ProviderEnumerationDate: 03/15/2011
LastUpdateDate: 09/01/2022
NPIDeactivationReasonCode:  
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NPIReactivationDate:  
ProviderGenderCode:  
AuthorizedOfficialLastName: CLOSSER
AuthorizedOfficialFirstName: SUE
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition: OWNER
AuthorizedOfficialTelephone: 4252124211
IsSoleProprietor:  
IsOrganizationSubpart: N
ParentOrganizationLBN:  
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AuthorizedOfficialCredential:  
NPICertificationDate: 09/01/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
251E00000XMTSW.FS.00001985WAY AgenciesHome Health 

No ID Information.


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