Provider Demographics
NPI:1982716569
Name:OCOSTA SCHOOL DISTRICT
Entity Type:Organization
Organization Name:OCOSTA SCHOOL DISTRICT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SUPERINTENDENT
Authorized Official - Prefix:
Authorized Official - First Name:HEATHER
Authorized Official - Middle Name:D
Authorized Official - Last Name:SWEET
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:360-268-9125
Mailing Address - Street 1:2580 S MONTESANO ST
Mailing Address - Street 2:
Mailing Address - City:WESTPORT
Mailing Address - State:WA
Mailing Address - Zip Code:98595-9746
Mailing Address - Country:US
Mailing Address - Phone:360-268-9125
Mailing Address - Fax:360-268-2540
Practice Address - Street 1:2580 S MONTESANO ST
Practice Address - Street 2:
Practice Address - City:WESTPORT
Practice Address - State:WA
Practice Address - Zip Code:98595-9746
Practice Address - Country:US
Practice Address - Phone:360-268-9125
Practice Address - Fax:360-268-2540
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-31
Last Update Date:2019-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA251300000X
251300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA7442908Medicaid