Provider Demographics
NPI:1265462469
Name:COLUMBIA SCHOOL DISTRICT BURBANK #400
Entity Type:Organization
Organization Name:COLUMBIA SCHOOL DISTRICT BURBANK #400
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SPECIAL PROGRAMS DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:LISA
Authorized Official - Middle Name:M
Authorized Official - Last Name:MUCHLINSKI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:509-545-8571
Mailing Address - Street 1:835 MAPLE ST
Mailing Address - Street 2:
Mailing Address - City:BURBANK
Mailing Address - State:WA
Mailing Address - Zip Code:99323-8534
Mailing Address - Country:US
Mailing Address - Phone:509-545-8571
Mailing Address - Fax:509-542-1798
Practice Address - Street 1:835 MAPLE ST
Practice Address - Street 2:
Practice Address - City:BURBANK
Practice Address - State:WA
Practice Address - Zip Code:99323-8534
Practice Address - Country:US
Practice Address - Phone:509-545-8571
Practice Address - Fax:509-542-1798
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-03
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
WA7442593Medicaid