Healthcare Provider Details

I. General information

NPI: 1023938222
Provider Name (Legal Business Name): EDUCATIONAL SERVICE DISTRICT 123
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/17/2026
Last Update Date: 07/17/2026
Certification Date: 07/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3924 W COURT ST
PASCO WA
99301-2775
US

IV. Provider business mailing address

3924 W COURT ST
PASCO WA
99301-2775
US

V. Phone/Fax

Practice location:
  • Phone: 509-547-8441
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: KENDRA PALOMAREZ
Title or Position: EXECUTIVE DIRECTOR OF STUDENT SERVI
Credential:
Phone: 509-537-1783