Provider Demographics
NPI:1609943158
Name:TOUTLE LAKE SCHOOL DISTRICT
Entity Type:Organization
Organization Name:TOUTLE LAKE SCHOOL DISTRICT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR-SPEC. EDUC. COOPERATIVE
Authorized Official - Prefix:
Authorized Official - First Name:ANN
Authorized Official - Middle Name:
Authorized Official - Last Name:HUTCHISON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:360-750-7507
Mailing Address - Street 1:5050 SPIRIT LAKE HWY
Mailing Address - Street 2:
Mailing Address - City:TOUTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98649-9701
Mailing Address - Country:US
Mailing Address - Phone:360-274-7615
Mailing Address - Fax:360-274-7608
Practice Address - Street 1:5050 SPIRIT LAKE HWY
Practice Address - Street 2:
Practice Address - City:TOUTLE
Practice Address - State:WA
Practice Address - Zip Code:98649-9701
Practice Address - Country:US
Practice Address - Phone:360-274-7615
Practice Address - Fax:360-274-7608
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-29
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
WA7440266Medicaid