Healthcare Provider Details

I. General information

NPI: 1366590655
Provider Name (Legal Business Name): WILLAMETTE EDUCATION SERVICE DISTRICT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/05/2007
Last Update Date: 08/11/2026
Certification Date: 08/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2611 PRINGLE RD SE
SALEM OR
97302-1533
US

IV. Provider business mailing address

2611 PRINGLE RD SE
SALEM OR
97302-1533
US

V. Phone/Fax

Practice location:
  • Phone: 503-385-4533
  • Fax:
Mailing address:
  • Phone: 503-385-4586
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code252Y00000X
TaxonomyEarly Intervention Provider Agency
License Number
License Number State

VIII. Authorized Official

Name: TONYA COKER
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 503-385-4586