NPIMap

Organization Active NPI

Educational Service District 112

  • Local Education Agency (LEA)
  • Castle Rock, WA
National Provider Identifier
1962752956
Registry record updated Sep 17, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Local Education Agency (LEA)Taxonomy code 251300000X
License
SP 60208742 Issued in WA
Legal business name
EDUCATIONAL SERVICE DISTRICT 112
Practice address
404 Balcer St NE
Castle Rock, WA 98611-9647
Phone
(360) 560-1030
NPI assigned
Sep 17, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 17, 2012

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

Authorized official

Name
Mrs. Nancy Sue King, SP60208742NPI 1689015109
Title
Speech Language Pathologist Assista
Phone
(360) 560-1030

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Local Education Agency (LEA) 251300000X SP 60208742 WA Primary

Addresses

Primary practice location

404 Balcer St NE
Castle Rock, WA 98611-9647

Mailing address

404 Balcer St NE
Castle Rock, WA 98611-9647
Phone (360) 560-1030

Other identifiers 1

IdentifierTypeStateIssuer
SP 60208742MedicaidWA

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.

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1347840000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1347840000000",
    "number": "1962752956",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "404 BALCER ST NE",
            "city": "CASTLE ROCK",
            "state": "WA",
            "postal_code": "986119647",
            "telephone_number": "360-560-1030"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "404 BALCER ST NE",
            "city": "CASTLE ROCK",
            "state": "WA",
            "postal_code": "986119647",
            "telephone_number": "360-560-1030"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EDUCATIONAL SERVICE DISTRICT 112",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-09-17",
        "last_updated": "2012-09-17",
        "status": "A",
        "authorized_official_last_name": "KING",
        "authorized_official_first_name": "NANCY",
        "authorized_official_middle_name": "SUE",
        "authorized_official_title_or_position": "SPEECH LANGUAGE PATHOLOGIST ASSISTA",
        "authorized_official_telephone_number": "360-560-1030",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "SP60208742"
    },
    "taxonomies": [
        {
            "code": "251300000X",
            "taxonomy_group": "",
            "desc": "Local Education Agency (LEA)",
            "state": "WA",
            "license": "SP 60208742",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "SP 60208742",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Castle Rock, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 2012; 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.