=====================================================
General NPI Number Information
=====================================================
NPI Number | 1225106214
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | SKAMANIA SCHOOL DISTRICT
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 11/30/2006
-----------------------------------------------------
Last Update Date | 08/22/2020
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | MPO 12 R BUTLER LOOP
-----------------------------------------------------
City | SKAMANIA
-----------------------------------------------------
State | WA
-----------------------------------------------------
Zip | 98648
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 509-427-8239
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | MPO 12 R BUTLER LOOP
-----------------------------------------------------
City | SKAMANIA
-----------------------------------------------------
State | WA
-----------------------------------------------------
Zip | 98648
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 509-427-8239
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | DIRECTOR-SPEC. EDUC. COOPERATIVE
-----------------------------------------------------
Name | ANN HUTCHISON
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 360-750-7507
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 251300000X
-----------------------------------------------------
Taxonomy Name | Local Education Agency (LEA)
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State | WA
-----------------------------------------------------