Organization Active NPI

Olympic Oesd114

  • Local Education Agency (LEA)
  • Kelso, WA
National Provider Identifier
1093921108
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Local Education Agency (LEA)Taxonomy code 251300000X
Legal business name
OLYMPIC OESD114
Practice address
2000 Allen St
Kelso, WA 98626-5002
Phone
(360) 405-5843
Fax
(360) 782-5081
NPI assigned
May 15, 2007
Last updated
Jul 21, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Walt Bigby
Title
Superintendent
Phone
(360) 405-5843

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Local Education Agency (LEA) 251300000X WA Primary

Addresses

Primary practice location

2000 Allen St
Kelso, WA 98626-5002

Mailing address

105 National Ave N
Bremerton, WA 98312-3537
Phone (360) 405-5843

Other identifiers 1

IdentifierTypeStateIssuer
1991231MedicaidWA

National Provider Directory

National Provider Directory
Tax ID family
Oesd 114 Prevention Treatment Center3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Locations

105 N National Ave
Bremerton, WA 98312
Phone (360) 405-5843

2000 Allen St
Kelso, WA 98626
Phone (360) 405-5843

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1179187200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1093921108",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "105 NATIONAL AVE N",
            "city": "BREMERTON",
            "state": "WA",
            "postal_code": "983123537",
            "telephone_number": "360-405-5843",
            "fax_number": "360-782-5081"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2000 ALLEN ST",
            "city": "KELSO",
            "state": "WA",
            "postal_code": "986265002",
            "telephone_number": "360-405-5843",
            "fax_number": "360-782-5081"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OLYMPIC OESD114",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-15",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "BIGBY",
        "authorized_official_first_name": "WALT",
        "authorized_official_title_or_position": "SUPERINTENDENT",
        "authorized_official_telephone_number": "360-405-5843",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "251300000X",
            "taxonomy_group": "",
            "desc": "Local Education Agency (LEA)",
            "state": "WA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1991231",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kelso, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.