| Sunrise Corporate Services, Llc | |
|
9300 Se 91st Ave Ste 201 Happy Valley OR 97086-3762 | |
| (503) 387-7111 | |
| (503) 567-7706 |
| Full Name | Sunrise Corporate Services, Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 9300 Se 91st Ave Ste 201, Happy Valley, Oregon |
| Authorized Official Name and Position | Inna Velychko (MANAGER) |
| Authorized Official Contact | 5033877111 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Sunrise Corporate Services, Llc Po Box 226 Brush Prairie WA 98606-0226 Ph: () - | Sunrise Corporate Services, Llc 9300 Se 91st Ave Ste 201 Happy Valley OR 97086-3762 Ph: (503) 387-7111 |
| NPI Number | 1316460876 |
|---|---|
| Provider Enumeration Date | 07/17/2017 |
| Last Update Date | 11/24/2017 |
| Medicare PECOS PAC ID | 1153695762 |
|---|---|
| Medicare Enrollment ID | O20170920003577 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1316460876 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Inna V Velychko |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1609036771 PECOS PAC ID: 2668506445 Enrollment ID: I20171025002980 |
| Provider Name | Tetyana O Odarich |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1437460193 PECOS PAC ID: 8123260817 Enrollment ID: I20171107003465 |
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