NPIMap

Organization Active NPI

Sunrise Haven

  • Religious Nonmedical Health Care Institution
  • Kent, WA
National Provider Identifier
1104895325
Registry record updated Oct 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Religious Nonmedical Health Care InstitutionTaxonomy code 282J00000X
License
1315 Issued in WA
Legal business name
SUNRISE HAVEN
Practice address
24423 100TH Ave SE
Kent, WA 98030
Phone
(253) 813-2096
NPI assigned
Mar 17, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 25, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Bonnie Demaree
Title
Business Manager
Phone
(253) 813-2096

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Religious Nonmedical Health Care Institution 282J00000X 1315 WA Primary

Addresses

Primary practice location

24423 100TH Ave SE
Kent, WA 98030

Mailing address

24423 100TH Ave SE
Kent, WA 98030-4846
Phone (253) 813-2096

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110517000712 WA Part A Provider - Religious Non-Medical Health Care Institution (Rnhci) 8628254182 Practice locations: Kent, WA

National Provider Directory

National Provider Directory

Locations

24423 100th Ave SE
Kent, WA 98030
Phone (253) 812-2096

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1142553600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1729814400000",
    "number": "1104895325",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24423 100TH AVE SE",
            "city": "KENT",
            "state": "WA",
            "postal_code": "980304846",
            "telephone_number": "253-813-2096",
            "fax_number": "253-852-5887"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24423 100TH AVE SE",
            "city": "KENT",
            "state": "WA",
            "postal_code": "98030",
            "telephone_number": "253-813-2096"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUNRISE HAVEN",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-03-17",
        "last_updated": "2024-10-25",
        "certification_date": "2024-10-25",
        "status": "A",
        "authorized_official_last_name": "DEMAREE",
        "authorized_official_first_name": "BONNIE",
        "authorized_official_title_or_position": "BUSINESS MANAGER",
        "authorized_official_telephone_number": "253-813-2096"
    },
    "taxonomies": [
        {
            "code": "282J00000X",
            "taxonomy_group": "",
            "desc": "Religious Nonmedical Health Care Institution",
            "state": "WA",
            "license": "1315",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kent, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.