Provider Demographics
NPI:1215022785
Name:DIXIE SCHOOL DISTRICT
Entity Type:Organization
Organization Name:DIXIE SCHOOL DISTRICT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:CONNIE
Authorized Official - Middle Name:L
Authorized Official - Last Name:HUETT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:509-525-5339
Mailing Address - Street 1:10520 E. HIGHWAY 12
Mailing Address - Street 2:PO BOX 40
Mailing Address - City:DIXIE
Mailing Address - State:WA
Mailing Address - Zip Code:99329
Mailing Address - Country:US
Mailing Address - Phone:509-525-5339
Mailing Address - Fax:509-525-1062
Practice Address - Street 1:10520 E. HIGHWAY 12
Practice Address - Street 2:
Practice Address - City:DIXIE
Practice Address - State:WA
Practice Address - Zip Code:99329
Practice Address - Country:US
Practice Address - Phone:509-525-5339
Practice Address - Fax:509-525-1062
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-03
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
WA7442957Medicaid