Roosevelt School District

Organization Active NPI Local Education Agency (LEA) · Roosevelt, WA

NPI 1356465744 · NPPES record last updated Aug 22, 2020

Key facts

NPI
1356465744
Entity type
Organization (NPI type 2)
Primary specialty
Local Education Agency (LEA) 251300000X
Legal business name
ROOSEVELT SCHOOL DISTRICT
Practice address
615 Chinook Avenue
Roosevelt, WA 99356
Phone
(509) 374-5462
NPI assigned
Mar 19, 2007
Organization subpart
No

Authorized official

Name
Bernice J Sundby
Title
Business Manager
Phone
(360) 750-7500

National Provider Directory

Specialties & licenses

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

Addresses

Primary practice location

615 Chinook Avenue
Roosevelt, WA 99356

Mailing address

615 Chinook Avenue
Roosevelt, WA 99356
Phone (509) 374-5462

Other identifiers

IdentifierTypeStateIssuer
7440233MedicaidWA

Sources for this page

Verify at the official NPI Registry.