Provider Demographics
NPI:1700247491
Name:LANE EDUCATION SERVICE DISTRICT
Entity type:Organization
Organization Name:LANE EDUCATION SERVICE DISTRICT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR, SPECIAL EDUCATION
Authorized Official - Prefix:
Authorized Official - First Name:SUE
Authorized Official - Middle Name:
Authorized Official - Last Name:MATHISEN
Authorized Official - Suffix:
Authorized Official - Credentials:MS
Authorized Official - Phone:541-461-8251
Mailing Address - Street 1:1200 HIGHWAY 99 N
Mailing Address - Street 2:
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97402-2014
Mailing Address - Country:US
Mailing Address - Phone:541-461-8251
Mailing Address - Fax:541-461-8298
Practice Address - Street 1:1200 HIGHWAY 99 N
Practice Address - Street 2:
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97402-2014
Practice Address - Country:US
Practice Address - Phone:541-461-8251
Practice Address - Fax:541-461-8298
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-03-09
Last Update Date:2016-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR261QS1000X, 251300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)
No261QS1000XAmbulatory Health Care FacilitiesClinic/CenterStudent Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR2064OtherEDUCATION