Healthcare Provider Details

I. General information

NPI: 1255246377
Provider Name (Legal Business Name): SUNNYSIDE SEATTLE THERAPY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/14/2026
Last Update Date: 08/14/2026
Certification Date: 08/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5719 40TH AVE NE
SEATTLE WA
98105-2218
US

IV. Provider business mailing address

5719 40TH AVE NE
SEATTLE WA
98105-2218
US

V. Phone/Fax

Practice location:
  • Phone: 206-992-8398
  • Fax:
Mailing address:
  • Phone: 206-992-8398
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: ABIGAIL SPEAR
Title or Position: OWNER
Credential: LICSW
Phone: 206-992-8398