Provider Demographics
NPI:1497649156
Name:DOUGLAS EDUCATION SERVICE DISTRICT
Entity type:Organization
Organization Name:DOUGLAS EDUCATION SERVICE DISTRICT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SUPERINTENDENT
Authorized Official - Prefix:
Authorized Official - First Name:ANALICIA
Authorized Official - Middle Name:
Authorized Official - Last Name:NICHOLSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:541-440-4753
Mailing Address - Street 1:1409 NE DIAMOND LAKE BLVD STE 110
Mailing Address - Street 2:
Mailing Address - City:ROSEBURG
Mailing Address - State:OR
Mailing Address - Zip Code:97470-3356
Mailing Address - Country:US
Mailing Address - Phone:541-440-4753
Mailing Address - Fax:
Practice Address - Street 1:1409 NE DIAMOND LAKE BLVD STE 110
Practice Address - Street 2:
Practice Address - City:ROSEBURG
Practice Address - State:OR
Practice Address - Zip Code:97470-3356
Practice Address - Country:US
Practice Address - Phone:541-440-4753
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-06-06
Last Update Date:2025-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251300000XAgenciesLocal Education Agency (LEA)
No163WS0200XNursing Service ProvidersRegistered NurseSchoolGroup - Multi-Specialty
No235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty