NPIMap

Organization Active NPI

Educational Service District 112

  • Local Education Agency (LEA)
  • Vancouver, WA
National Provider Identifier
1922238526
Registry record updated Jul 17, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Local Education Agency (LEA)Taxonomy code 251300000X
Legal business name
EDUCATIONAL SERVICE DISTRICT 112
Practice address
2500 NE 65TH Ave
Vancouver, WA 98661-6812
Phone
(360) 750-7507
Fax
(360) 906-1010
NPI assigned
Jul 17, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 17, 2009

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

Authorized official

Name
Sandy Mathewson
Title
Prevention Center Director
Phone
(360) 750-7505

Specialties & licenses 1

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

Addresses

Primary practice location

2500 NE 65TH Ave
Vancouver, WA 98661-6812

Mailing address

2500 NE 65TH Ave
Vancouver, WA 98661-6812
Phone (360) 750-7507

Other identifiers 1

IdentifierTypeStateIssuer
1995877OtherWAPROVIDER NUMBER USED WHEN BILLING TITLE XIX

National Provider Directory

National Provider Directory
Tax ID family
Educational Service District 1126 organizations share this tax ID, including this one

Other organizations with this tax ID 5

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

NPI Registry JSON

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

{
    "created_epoch": "1247788800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1247788800000",
    "number": "1922238526",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2500 NE 65TH AVE",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986616812",
            "telephone_number": "360-750-7507",
            "fax_number": "360-906-1010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2500 NE 65TH AVE",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986616812",
            "telephone_number": "360-750-7507",
            "fax_number": "360-906-1010"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EDUCATIONAL SERVICE DISTRICT 112",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-07-17",
        "last_updated": "2009-07-17",
        "status": "A",
        "authorized_official_last_name": "MATHEWSON",
        "authorized_official_first_name": "SANDY",
        "authorized_official_title_or_position": "PREVENTION CENTER DIRECTOR",
        "authorized_official_telephone_number": "360-750-7505"
    },
    "taxonomies": [
        {
            "code": "251300000X",
            "taxonomy_group": "",
            "desc": "Local Education Agency (LEA)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PROVIDER NUMBER USED WHEN BILLING TITLE XIX",
            "identifier": "1995877",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Vancouver, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2009; 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.