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General NPI Number Information
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NPI Number | 1104050210
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Entity Type | Organization
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Legal Business Name | SUNRISE THERAPY, LLC
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Dates
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Enumeration Date | 05/05/2009
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Last Update Date | 06/04/2009
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Provider Practice Location Address
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Address Line | 2310 A ST
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City | TACOMA
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State | WA
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Zip | 98402-2912
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Country | US
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Telephone | 253-820-5791
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Fax |
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Provider Business Mailing Address
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Address Line | 4806 N 29TH ST
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City | TACOMA
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State | WA
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Zip | 98407-3922
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Country | US
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Telephone | 253-820-5791
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | ALICIA MARIE SAVAGE
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Credential | OTR/L
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Telephone | 253-820-5791
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | OT00004416
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License Number State | WA
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