Provider Demographics
NPI:1689769275
Name:EPHRATA SCHOOL DISTRICT
Entity Type:Organization
Organization Name:EPHRATA SCHOOL DISTRICT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SPECIAL EDUCATION DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:TRAVIS
Authorized Official - Middle Name:
Authorized Official - Last Name:ELOFF
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:509-754-3538
Mailing Address - Street 1:501 'C' ST NW
Mailing Address - Street 2:
Mailing Address - City:EPHRATA
Mailing Address - State:WA
Mailing Address - Zip Code:98823
Mailing Address - Country:US
Mailing Address - Phone:509-754-2474
Mailing Address - Fax:509-754-4712
Practice Address - Street 1:501 'C' ST NW
Practice Address - Street 2:
Practice Address - City:EPHRATA
Practice Address - State:WA
Practice Address - Zip Code:98823
Practice Address - Country:US
Practice Address - Phone:509-754-2474
Practice Address - Fax:509-754-4712
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-03
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
WA7441587Medicaid