Provider Demographics
NPI:1952478182
Name:GLENWOOD SCHOOL DISTRICT
Entity Type:Organization
Organization Name:GLENWOOD SCHOOL DISTRICT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR- SPEC. EDUC. COOPERATIVE
Authorized Official - Prefix:
Authorized Official - First Name:ANN
Authorized Official - Middle Name:
Authorized Official - Last Name:HUTCHISON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:360-750-7500
Mailing Address - Street 1:320 BUNNELL STREET
Mailing Address - Street 2:
Mailing Address - City:GLENWOOD
Mailing Address - State:WA
Mailing Address - Zip Code:98619
Mailing Address - Country:US
Mailing Address - Phone:509-364-3438
Mailing Address - Fax:
Practice Address - Street 1:320 BUNNELL STREET
Practice Address - Street 2:
Practice Address - City:GLENWOOD
Practice Address - State:WA
Practice Address - Zip Code:98619
Practice Address - Country:US
Practice Address - Phone:509-364-3438
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-30
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
WA7442585Medicaid