Healthcare Provider Details

I. General information

NPI: 1487084109
Provider Name (Legal Business Name): SEATTLE PUBLIC SCHOOLS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/15/2013
Last Update Date: 11/15/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2445 3RD AVE S SMAIL STOP: 31-650
SEATTLE WA
98134-1923
US

IV. Provider business mailing address

2445 3RD AVE S SMAIL STOP: 31-650
SEATTLE WA
98134-1923
US

V. Phone/Fax

Practice location:
  • Phone: 206-252-0752
  • Fax: 206-252-0751
Mailing address:
  • Phone: 206-252-0752
  • Fax: 206-252-0751

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WS0200X
TaxonomySchool Registered Nurse
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License NumberRN.0080165
License Number StateWA

VIII. Authorized Official

Name: KATHLEEN JOHNSON
Title or Position: MANAGER- STUDENT HEALTH SVCS
Credential:
Phone: 206-252-0752