Healthcare Provider Details

I. General information

NPI: 1982716569
Provider Name (Legal Business Name): OCOSTA SCHOOL DISTRICT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/31/2006
Last Update Date: 03/21/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2580 S MONTESANO ST
WESTPORT WA
98595-9746
US

IV. Provider business mailing address

2580 S MONTESANO ST
WESTPORT WA
98595-9746
US

V. Phone/Fax

Practice location:
  • Phone: 360-268-9125
  • Fax: 360-268-2540
Mailing address:
  • Phone: 360-268-9125
  • Fax: 360-268-2540

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251300000X
TaxonomyLocal Education Agency (LEA)
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code251300000X
TaxonomyLocal Education Agency (LEA)
License Number
License Number StateWA

VIII. Authorized Official

Name: HEATHER D SWEET
Title or Position: SUPERINTENDENT
Credential:
Phone: 360-268-9125