Provider Demographics
NPI:1144254731
Name:NOOKSACK VALLEY SCHOOL DISTRICT
Entity type:Organization
Organization Name:NOOKSACK VALLEY SCHOOL DISTRICT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMIN. ASST. FOR EDUC. SERVICES
Authorized Official - Prefix:MRS
Authorized Official - First Name:CAROL
Authorized Official - Middle Name:
Authorized Official - Last Name:LAGASSE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:360-988-4754
Mailing Address - Street 1:PO BOX 4307
Mailing Address - Street 2:
Mailing Address - City:NOOKSACK
Mailing Address - State:WA
Mailing Address - Zip Code:98276-0307
Mailing Address - Country:US
Mailing Address - Phone:360-988-4754
Mailing Address - Fax:360-988-8983
Practice Address - Street 1:3326 E BADGER RD
Practice Address - Street 2:
Practice Address - City:EVERSON
Practice Address - State:WA
Practice Address - Zip Code:98247-9232
Practice Address - Country:US
Practice Address - Phone:360-988-4754
Practice Address - Fax:360-988-8983
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-10
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA251300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA7440928Medicaid