Provider Demographics
NPI:1134228042
Name:TUMWATERSCHOOL DISTRICT
Entity type:Organization
Organization Name:TUMWATERSCHOOL DISTRICT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTATIVE ASST.
Authorized Official - Prefix:MRS
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:J
Authorized Official - Last Name:LOGUE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:360-709-7040
Mailing Address - Street 1:419 LINWOOD AVE SW
Mailing Address - Street 2:
Mailing Address - City:TUMWATER
Mailing Address - State:WA
Mailing Address - Zip Code:98512-6845
Mailing Address - Country:US
Mailing Address - Phone:360-709-7040
Mailing Address - Fax:360-709-7042
Practice Address - Street 1:419 LINWOOD AVE SW
Practice Address - Street 2:
Practice Address - City:TUMWATER
Practice Address - State:WA
Practice Address - Zip Code:98512-6845
Practice Address - Country:US
Practice Address - Phone:360-709-7040
Practice Address - Fax:360-709-7042
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-21
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
WA7440803Medicaid