Healthcare Provider Details

I. General information

NPI: 1336491018
Provider Name (Legal Business Name): TACOMA SCHOOL DISTRICT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/05/2012
Last Update Date: 10/05/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1721 8TH AVE. S.W.
PUYALLUP WA
98371
US

IV. Provider business mailing address

1721 8TH AVE SW
PUYALLUP WA
98371-6603
US

V. Phone/Fax

Practice location:
  • Phone: 253-845-0240
  • Fax:
Mailing address:
  • Phone: 253-845-0240
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License NumberP1 60038241
License Number StateWA

VIII. Authorized Official

Name: JENNIFER TRAUFLER
Title or Position: SPECIAL ED. DIRECTOR
Credential:
Phone: 253-571-1000