Healthcare Provider Details

I. General information

NPI: 1639947849
Provider Name (Legal Business Name): RISING SUN THERAPY SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/18/2023
Last Update Date: 03/03/2024
Certification Date: 03/03/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18947 111TH AVENUE CT E
PUYALLUP WA
98374-6495
US

IV. Provider business mailing address

18947 111TH AVENUE CT E
PUYALLUP WA
98374-6495
US

V. Phone/Fax

Practice location:
  • Phone: 509-631-9931
  • Fax:
Mailing address:
  • Phone: 509-631-9931
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QH0700X
TaxonomyHearing and Speech Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: ROSAN ORTIZ ANAYA
Title or Position: SPEECH LANGUAGE PATHOLOGIST- OWNER
Credential: MS., CCC-SLP
Phone: 509-631-9931