MEDICARE: WASHINGTON ELEMENTARY SCHOOL DISTRICT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251300000X	Local Education Agency (LEA)

General Provider Information

NPI Number	:	1689708877
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WASHINGTON ELEMENTARY SCHOOL DISTRICT

Provider Business Mailing Address
First Line	:	5222 EAST KAREN DRIVE
Second Line	:
City	:	SCOTTSDALE
State	:	AZ
Zip	:	85254
Country	:	US
Telephone Number	:	602-373-1238
Fax Number	:

Provider Business Practice Location Address
First Line	:	7502 NORTH 39TH AVENUE
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85051
Country	:	US
Telephone Number	:	602-347-2513
Fax Number	:

Authorized Official
Title or Position	:	PSYCHOLOGIST
Name	:	MR. KEVIN GLEN BROWN
Credential	:	M.S.
Telephone Number	:	602-347-2513

Provider Enumeration Date	:	03/16/2007
Last Update Date	:	08/22/2020

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