Provider Demographics
NPI:1568573269
Name:CLARKSTON SCHOOL DISTRICT
Entity Type:Organization
Organization Name:CLARKSTON SCHOOL DISTRICT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF STUDENT SERVICES
Authorized Official - Prefix:MRS
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:
Authorized Official - Last Name:HALL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:509-769-6349
Mailing Address - Street 1:1294 CHESTNUT ST
Mailing Address - Street 2:PO BOX 70
Mailing Address - City:CLARKSTON
Mailing Address - State:WA
Mailing Address - Zip Code:99403-2557
Mailing Address - Country:US
Mailing Address - Phone:509-769-6349
Mailing Address - Fax:509-758-8139
Practice Address - Street 1:1294 CHESTNUT ST
Practice Address - Street 2:
Practice Address - City:CLARKSTON
Practice Address - State:WA
Practice Address - Zip Code:99403-2557
Practice Address - Country:US
Practice Address - Phone:509-769-6349
Practice Address - Fax:509-758-8139
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-31
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
WA7440001Medicaid