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NPI Code Detail

MEDICARE: CENTRALIA SCHOOL DISTRICT #401

MEDICARE: CENTRALIA SCHOOL DISTRICT #401
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)WA

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 : 1750310405
Entity Type Code : Organization
Provider Name (Legal Business Name) : CENTRALIA SCHOOL DISTRICT #401
Provider Business Mailing Address
First Line : 2320 BORST AVENUE
Second Line : PO BOX 610
City : CENTRALIA
State : WA
Zip : 98531-1410
Country : US
Telephone Number : 360-330-7600
Fax Number : 360-807-2888
Provider Business Practice Location Address
First Line : 2320 BORST AVENUE
Second Line :
City : CENTRALIA
State : WA
Zip : 98531-1410
Country : US
Telephone Number : 360-330-7600
Fax Number : 360-807-2888
Authorized Official
Title or Position : EXECUTIVE DIRECTOR OF FISCAL SERVIC
Name : JOSEPH VETTER
Credential :
Telephone Number : 360-330-7600
Provider Enumeration Date : 07/02/2006
Last Update Date : 02/10/2026

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Directions to “CENTRALIA SCHOOL DISTRICT #401 ” Practice Location

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