Provider Demographics
NPI:1265770671
Name:SEATTLESCHOOLDISTRICT1
Entity type:Organization
Organization Name:SEATTLESCHOOLDISTRICT1
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:SUPERVISOR
Authorized Official - Prefix:MS
Authorized Official - First Name:JILL
Authorized Official - Middle Name:
Authorized Official - Last Name:LEWIS
Authorized Official - Suffix:
Authorized Official - Credentials:ANRP
Authorized Official - Phone:206-252-0752
Mailing Address - Street 1:1410 NE 66TH ST
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98115-6744
Mailing Address - Country:US
Mailing Address - Phone:206-252-4817
Mailing Address - Fax:206-252-4811
Practice Address - Street 1:1410 NE 66TH ST
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98115-6744
Practice Address - Country:US
Practice Address - Phone:206-252-4817
Practice Address - Fax:206-252-4811
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SEATTLEPUBLICSCHOOLS
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2013-01-18
Last Update Date:2013-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARN00053208251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health