Provider Demographics
NPI:1740206325
Name:PORT TOWNSEND SCHOOL DISTRICT
Entity Type:Organization
Organization Name:PORT TOWNSEND SCHOOL DISTRICT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF FINANCE AND BUSINESS OP
Authorized Official - Prefix:MRS
Authorized Official - First Name:AMY
Authorized Official - Middle Name:
Authorized Official - Last Name:KHILE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:360-680-5757
Mailing Address - Street 1:450 FIR ST
Mailing Address - Street 2:
Mailing Address - City:PORT TOWNSEND
Mailing Address - State:WA
Mailing Address - Zip Code:98368-6441
Mailing Address - Country:US
Mailing Address - Phone:360-379-4503
Mailing Address - Fax:360-385-3617
Practice Address - Street 1:1610 BLAINE ST
Practice Address - Street 2:
Practice Address - City:PORT TOWNSEND
Practice Address - State:WA
Practice Address - Zip Code:98368-6405
Practice Address - Country:US
Practice Address - Phone:360-680-5759
Practice Address - Fax:360-385-3617
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-15
Last Update Date:2023-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA251300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA7440472Medicaid