Healthcare Provider Details

I. General information

NPI: 1225465610
Provider Name (Legal Business Name): AUBURN SCHOOL DISTRICT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/01/2013
Last Update Date: 10/01/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7702 195TH AVENUE CT E
BONNEY LAKE WA
98391-7159
US

IV. Provider business mailing address

7702 195TH AVENUE CT E
BONNEY LAKE WA
98391-7159
US

V. Phone/Fax

Practice location:
  • Phone: 253-261-5558
  • Fax:
Mailing address:
  • Phone: 253-261-5558
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251300000X
TaxonomyLocal Education Agency (LEA)
License NumberLP 60396795
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code385H00000X
TaxonomyRespite Care
License NumberLP 60396795
License Number StateWA

VIII. Authorized Official

Name: MS. JULIE ANN BYERLEY
Title or Position: NURSE
Credential: LPN
Phone: 253-261-5558