MEDICARE: SANRISE HOMECARE LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	253Z00000X	In Home Supportive Care Agency

General Provider Information

NPI Number	:	1013806389
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SANRISE HOMECARE LLC

Provider Business Mailing Address
First Line	:	2211 S STAR LAKE RD APT 20-204
Second Line	:
City	:	FEDERAL WAY
State	:	WA
Zip	:	98003-2863
Country	:	US
Telephone Number	:	206-742-7653
Fax Number	:

Provider Business Practice Location Address
First Line	:	2211 S STAR LAKE RD APT 20-204
Second Line	:
City	:	FEDERAL WAY
State	:	WA
Zip	:	98003-2863
Country	:	US
Telephone Number	:	206-742-7653
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	ANASTASIA JEPKORIR
Credential	:
Telephone Number	:	206-627-9961

Provider Enumeration Date	:	07/01/2025
Last Update Date	:	07/01/2025

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