Provider Demographics
NPI:1669488516
Name:ROCHESTER SCHOOL DISTRICT
Entity Type:Organization
Organization Name:ROCHESTER SCHOOL DISTRICT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SPECIAL SERVICES DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:CINDY
Authorized Official - Middle Name:
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:360-273-6522
Mailing Address - Street 1:9917 HIGHWAY 12 SW
Mailing Address - Street 2:PO BOX 457
Mailing Address - City:ROCHESTER
Mailing Address - State:WA
Mailing Address - Zip Code:98579
Mailing Address - Country:US
Mailing Address - Phone:360-273-5536
Mailing Address - Fax:360-273-5547
Practice Address - Street 1:9917 HIGHWAY 12 SW
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:WA
Practice Address - Zip Code:98579
Practice Address - Country:US
Practice Address - Phone:360-273-5536
Practice Address - Fax:360-273-5547
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-31
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
WA7442148Medicaid