Healthcare Provider Details

I. General information

NPI: 1174037550
Provider Name (Legal Business Name): NORTH CENTRAL EDUCATIONAL SERVICE DISTRICT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/21/2017
Last Update Date: 11/21/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

430 OLDS STATION RD
WENATCHEE WA
98801-5975
US

IV. Provider business mailing address

430 OLDS STATION RD
WENATCHEE WA
98801-5975
US

V. Phone/Fax

Practice location:
  • Phone: 509-665-2610
  • Fax: 509-662-9027
Mailing address:
  • Phone: 509-665-2610
  • Fax: 509-662-9027

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code252Y00000X
TaxonomyEarly Intervention Provider Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MISS TRISHA DEE SCHOCK
Title or Position: ASSISTANT FISCAL DIRECTOR
Credential:
Phone: 509-667-3637