Provider Demographics
NPI:1316286958
Name:ORTIZ SUNRISE COUNSELING SERVICES CO
Entity type:Organization
Organization Name:ORTIZ SUNRISE COUNSELING SERVICES CO
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:FERNANDO
Authorized Official - Middle Name:
Authorized Official - Last Name:ORTIZ
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:509-313-6126
Mailing Address - Street 1:502 E BOONE AVE # AD94
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99258-0094
Mailing Address - Country:US
Mailing Address - Phone:509-313-6126
Mailing Address - Fax:509-313-4049
Practice Address - Street 1:502 E BOONE AVE # AD94
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99258-0094
Practice Address - Country:US
Practice Address - Phone:509-313-6126
Practice Address - Fax:509-313-4049
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ORTIZ SUNRISE COUNSELING SERVICES CO
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2013-02-01
Last Update Date:2013-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA603255051251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health