Healthcare Provider Details
I. General information
NPI: 1295690485
Provider Name (Legal Business Name): SUNRISE SERVICES INC.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 12/19/2025
Last Update Date: 12/19/2025
Certification Date: 12/19/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
811 MADISON ST
EVERETT WA
98203-4543
US
IV. Provider business mailing address
3512 204TH ST SW APT H205
LYNNWOOD WA
98036-6889
US
V. Phone/Fax
- Phone: 425-493-5831
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 273R00000X |
| Taxonomy | Psychiatric Hospital Unit |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
MASTEWAL
MENGESHA
Title or Position: INDIVIDUAL PROVIDER
Credential:
Phone: 425-534-3578