Healthcare Provider Details

I. General information

NPI: 1013092550
Provider Name (Legal Business Name): SUNRISE SERVICES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/25/2006
Last Update Date: 05/19/2023
Certification Date: 05/19/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1718 BROADWAY
EVERETT WA
98201-2347
US

IV. Provider business mailing address

PO BOX 2569
EVERETT WA
98213-0569
US

V. Phone/Fax

Practice location:
  • Phone: 425-595-5200
  • Fax: 425-595-5201
Mailing address:
  • Phone: 425-493-5800
  • Fax: 425-493-5801

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QM1300X
TaxonomyMulti-Specialty Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MS. SUE A. CLOSSER
Title or Position: CEO
Credential:
Phone: 425-493-5800