NPIMap

Organization Active NPI

Sunrise ABA of Washington LLC

  • Behavior Analyst
  • Bothell, WA
National Provider Identifier
1740919422
Registry record updated Apr 30, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
Legal business name
SUNRISE ABA OF WASHINGTON LLC
Practice address
19919 Bartlett Rd
Bothell, WA 98012-9645
Phone
(707) 799-9527
NPI assigned
Jun 7, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 30, 2023

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

Authorized official

Name
Brady Keith
Title
Director of Operations
Phone
(628) 250-7500

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior AnalystGroup: 193200000X MULTI-SPECIALTY GROUP 103K00000X Primary

Addresses

Primary practice location

19919 Bartlett Rd
Bothell, WA 98012-9645

Mailing address

505 San Marin Dr
Novato, CA 94945-1309
Phone (707) 799-9527

Other names 1

  • SunRise ABA Former legal business name

National Provider Directory

National Provider Directory

Locations

505 San Marin Dr
Novato, CA 94945
Phone (415) 895-5360

Practitioners & affiliated clinicians

Practitioners 7

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": "1654560000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1682812800000",
    "number": "1740919422",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "505 SAN MARIN DR",
            "city": "NOVATO",
            "state": "CA",
            "postal_code": "949451309",
            "telephone_number": "707-799-9527"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19919 BARTLETT RD",
            "city": "BOTHELL",
            "state": "WA",
            "postal_code": "980129645",
            "telephone_number": "707-799-9527"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUNRISE ABA OF WASHINGTON LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-06-07",
        "last_updated": "2023-04-30",
        "certification_date": "2023-04-30",
        "status": "A",
        "authorized_official_last_name": "KEITH",
        "authorized_official_first_name": "BRADY",
        "authorized_official_title_or_position": "DIRECTOR OF OPERATIONS",
        "authorized_official_telephone_number": "628-250-7500"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SunRise ABA",
            "code": "4",
            "type": "Former Legal Business Name"
        },
        {
            "organization_name": "SunRise ABA",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Bothell, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.