Provider Demographics
NPI:1982707030
Name:NACHES VALLEY SCHOOL DISTRICT
Entity Type:Organization
Organization Name:NACHES VALLEY SCHOOL DISTRICT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF SPECIAL SERVICES
Authorized Official - Prefix:MS
Authorized Official - First Name:LORI
Authorized Official - Middle Name:A
Authorized Official - Last Name:GYLLING
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:509-653-2122
Mailing Address - Street 1:26 SHAFER AVENUE
Mailing Address - Street 2:PO BOX 99
Mailing Address - City:NACHES
Mailing Address - State:WA
Mailing Address - Zip Code:98937-0099
Mailing Address - Country:US
Mailing Address - Phone:509-653-2122
Mailing Address - Fax:509-653-1211
Practice Address - Street 1:26 SHAFER AVENUE
Practice Address - Street 2:
Practice Address - City:NACHES
Practice Address - State:WA
Practice Address - Zip Code:98937-0099
Practice Address - Country:US
Practice Address - Phone:509-653-2122
Practice Address - Fax:509-653-1211
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-06
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
WA7442254Medicaid