Provider Demographics
NPI:1679504773
Name:KENNEWICK SCHOOL DISTRICT #17
Entity Type:Organization
Organization Name:KENNEWICK SCHOOL DISTRICT #17
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COORDINATOR OF SPECIAL EDUCATION
Authorized Official - Prefix:MS
Authorized Official - First Name:COLEEN
Authorized Official - Middle Name:
Authorized Official - Last Name:CULMER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:509-222-6483
Mailing Address - Street 1:200 S DAYTON ST
Mailing Address - Street 2:
Mailing Address - City:KENNEWICK
Mailing Address - State:WA
Mailing Address - Zip Code:99336-5633
Mailing Address - Country:US
Mailing Address - Phone:509-222-6483
Mailing Address - Fax:
Practice Address - Street 1:200 S DAYTON ST
Practice Address - Street 2:
Practice Address - City:KENNEWICK
Practice Address - State:WA
Practice Address - Zip Code:99336-5633
Practice Address - Country:US
Practice Address - Phone:509-222-6483
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-06
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
WA7442296Medicaid