Healthcare Provider Details

I. General information

NPI: 1265367866
Provider Name (Legal Business Name): SUNNYSIDE HOMECARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/15/2026
Last Update Date: 06/15/2026
Certification Date: 06/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8208 14TH AVE E
TACOMA WA
98404-3303
US

IV. Provider business mailing address

8208 14TH AVE E
TACOMA WA
98404-3303
US

V. Phone/Fax

Practice location:
  • Phone: 253-407-9889
  • Fax: 253-264-1696
Mailing address:
  • Phone: 253-407-9889
  • Fax: 253-264-1696

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code311ZA0620X
TaxonomyAdult Care Home Facility
License Number
License Number State

VIII. Authorized Official

Name: DIDI NNEKA OSSAI
Title or Position: PROVIDER
Credential:
Phone: 253-407-9889