Provider Demographics
NPI:1851510960
Name:EDUCATIONAL SERVICE DISTRICT 113
Entity Type:Organization
Organization Name:EDUCATIONAL SERVICE DISTRICT 113
Other - Org Name:LEWIS COUNTY SPECIAL EDUCATION COOP
Other - Org Type:Other Name
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:REBECCA
Authorized Official - Middle Name:J
Authorized Official - Last Name:TURNBULL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:360-748-3384
Mailing Address - Street 1:601 MCPHEE RD SW
Mailing Address - Street 2:
Mailing Address - City:OLYMPIA
Mailing Address - State:WA
Mailing Address - Zip Code:98502-5080
Mailing Address - Country:US
Mailing Address - Phone:360-464-6700
Mailing Address - Fax:
Practice Address - Street 1:601 MCPHEE RD SW
Practice Address - Street 2:
Practice Address - City:OLYMPIA
Practice Address - State:WA
Practice Address - Zip Code:98502-5080
Practice Address - Country:US
Practice Address - Phone:360-464-6700
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-25
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041S0200XBehavioral Health & Social Service ProvidersSocial WorkerSchoolGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA7442650Medicaid