Provider Demographics
NPI:1154449700
Name:BREWSTER SCHOOL DISTRICT 111-203J
Entity Type:Organization
Organization Name:BREWSTER SCHOOL DISTRICT 111-203J
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PAYROLL PROFESSIONAL
Authorized Official - Prefix:
Authorized Official - First Name:JANE
Authorized Official - Middle Name:
Authorized Official - Last Name:MCGUIRE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:509-689-3418
Mailing Address - Street 1:PO BOX 97
Mailing Address - Street 2:
Mailing Address - City:BREWSTER
Mailing Address - State:WA
Mailing Address - Zip Code:98812-0097
Mailing Address - Country:US
Mailing Address - Phone:509-689-3418
Mailing Address - Fax:509-689-2892
Practice Address - Street 1:503 S SEVENTH STREET
Practice Address - Street 2:
Practice Address - City:BREWSTER
Practice Address - State:WA
Practice Address - Zip Code:98812-0097
Practice Address - Country:US
Practice Address - Phone:509-689-3418
Practice Address - Fax:509-689-2892
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-26
Last Update Date:2008-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA7441090Medicaid
WA7441090Medicaid