Basic Information
| Provider Information | |||||||||
| NPI: | 1730549866 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | SUNRISE SERVICES, INC. | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 2569 | ||||||||
| Address2: | |||||||||
| City: | EVERETT | ||||||||
| State: | WA | ||||||||
| PostalCode: | 982130569 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4252124211 | ||||||||
| FaxNumber: | 4253470492 | ||||||||
| Practice Location | |||||||||
| Address1: | 101 NE BIRCH ST | ||||||||
| Address2: | |||||||||
| City: | COUPEVILLE | ||||||||
| State: | WA | ||||||||
| PostalCode: | 982393133 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4252124200 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 03/02/2016 | ||||||||
| LastUpdateDate: | 09/01/2022 | ||||||||
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| AuthorizedOfficialLastName: | CLOSSER | ||||||||
| AuthorizedOfficialFirstName: | SUE | ||||||||
| AuthorizedOfficialMiddleName: | A. | ||||||||
| AuthorizedOfficialTitleorPosition: | OWNER | ||||||||
| AuthorizedOfficialTelephone: | 4252124211 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MS. | ||||||||
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| NPICertificationDate: | 09/01/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 261QM1300X | N | Ambulatory Health Care Facilities | Clinic/Center | Multi-Specialty | 251S00000X | 600231010 | WA | Y | Agencies | Community/Behavioral Health |
No ID Information.