Healthcare Provider Details

I. General information

NPI: 1366553083
Provider Name (Legal Business Name): FEDERAL WAY SCHOOL DISTRICT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/31/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

31405 18TH AVE S
FEDERAL WAY WA
98003-5433
US

IV. Provider business mailing address

31405 18TH AVE S
FEDERAL WAY WA
98003-5433
US

V. Phone/Fax

Practice location:
  • Phone: 253-945-2087
  • Fax: 253-945-2177
Mailing address:
  • Phone: 253-945-2087
  • Fax: 253-945-2177

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251300000X
TaxonomyLocal Education Agency (LEA)
License Number
License Number StateWA

VIII. Authorized Official

Name: MR. CHRIS WILLIS
Title or Position: CO-DIRECTOR STUD. SUPPORT SERVICES
Credential:
Phone: 253-945-2084