Liberty School District

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

NPI 1376576587 · NPPES record last updated Aug 22, 2020

Key facts

NPI
1376576587
Entity type
Organization (NPI type 2)
Primary specialty
Local Education Agency (LEA) 251300000X
Legal business name
LIBERTY SCHOOL DISTRICT
Practice address
29818 S North Pine Creek Rd
Spangle, WA 99031-9707
Phone
(509) 245-3223
Fax
(509) 245-3288
NPI assigned
Jul 9, 2006
Organization subpart
No

Authorized official

Name
Mrs. Gracie P Hodgson
Title
Special Services
Phone
(509) 245-3211

Laboratory certificates & supplier records

Name & address match These CMS records do not include an NPI. They are shown here because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
50D2219247Liberty School District
29818 S North Pine Creek Rd, Spangle, WA 99031
Certificate of waiverApr 4, 2028

National Provider Directory

Locations

29818 N Pine Creek Rd
Spangle, WA 99031
Phone (509) 245-3223

Specialties & licenses

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

Addresses

Primary practice location

29818 S North Pine Creek Rd
Spangle, WA 99031-9707

Mailing address

29818 S North Pine Creek Rd
Spangle, WA 99031-9707
Phone (509) 245-3223

Other identifiers

IdentifierTypeStateIssuer
7441215MedicaidWA

Other providers in Spangle, WA

All providers in Spangle, WA · Local Education Agency (LEA) in Washington

Sources for this page

Verify at the official NPI Registry.