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NPI Code Detail

MEDICARE: WILLAMETTE EDUCATION SERVICE DISTRICT

MEDICARE: WILLAMETTE EDUCATION SERVICE 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
1251300000XLocal Education Agency (LEA)

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1699823567
Entity Type Code : Organization
Provider Name (Legal Business Name) : WILLAMETTE EDUCATION SERVICE DISTRICT
Provider Business Mailing Address
First Line : 2611 PRINGLE RD SE
Second Line :
City : SALEM
State : OR
Zip : 97302-1533
Country : US
Telephone Number : 503-588-5330
Fax Number :
Provider Business Practice Location Address
First Line : 2611 PRINGLE RD SE
Second Line :
City : SALEM
State : OR
Zip : 97302-1533
Country : US
Telephone Number : 503-588-5330
Fax Number :
Authorized Official
Title or Position : EXECUTIVE DIRECTOR
Name : TONYA COKER
Credential :
Telephone Number : 503-385-4586
Provider Enumeration Date : 01/08/2007
Last Update Date : 01/06/2025

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Directions to “WILLAMETTE EDUCATION SERVICE DISTRICT ” Practice Location

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