Healthcare Provider Details

I. General information

NPI: 1669488516
Provider Name (Legal Business Name): ROCHESTER SCHOOL DISTRICT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/31/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9917 HIGHWAY 12 SW
ROCHESTER WA
98579
US

IV. Provider business mailing address

9917 HIGHWAY 12 SW PO BOX 457
ROCHESTER WA
98579
US

V. Phone/Fax

Practice location:
  • Phone: 360-273-5536
  • Fax: 360-273-5547
Mailing address:
  • Phone: 360-273-5536
  • Fax: 360-273-5547

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: CINDY SMITH
Title or Position: SPECIAL SERVICES DIRECTOR
Credential:
Phone: 360-273-6522