Provider Demographics
NPI:1033135603
Name:PENINSULA SCHOOL DISTRICT
Entity Type:Organization
Organization Name:PENINSULA SCHOOL DISTRICT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF STUDENT SERVICES
Authorized Official - Prefix:DR
Authorized Official - First Name:SARAH
Authorized Official - Middle Name:
Authorized Official - Last Name:DRINKWATER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:253-530-1081
Mailing Address - Street 1:14015 62ND AVE NW
Mailing Address - Street 2:
Mailing Address - City:GIG HARBOR
Mailing Address - State:WA
Mailing Address - Zip Code:98332-8607
Mailing Address - Country:US
Mailing Address - Phone:253-530-1083
Mailing Address - Fax:253-530-1085
Practice Address - Street 1:14015 62ND AVE NW
Practice Address - Street 2:
Practice Address - City:GIG HARBOR
Practice Address - State:WA
Practice Address - Zip Code:98332-8607
Practice Address - Country:US
Practice Address - Phone:253-530-1083
Practice Address - Fax:253-530-1085
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-15
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA251300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA7441421Medicaid