Educational Service District 112

NPI #1962752956 in Castle Rock, Washington

Provider Information

NPI Number: 1962752956
Entity Type: Organization
Organization Name: Educational Service District 112
Primary Specialty: Local Education Agency (LEA)
Enumeration Date: Sep 17, 2012
Last Updated: Sep 17, 2012

Practice Location

Address: 404 BALCER ST NE
City: Castle Rock
State: Washington
ZIP Code: 98611-9647
Phone: (360) 560-1030

Authorized Official

Name: MRS. NANCY SUE KING, SP60208742
Title: SPEECH LANGUAGE PATHOLOGIST ASSISTA
Phone: (360) 560-1030

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Local Education Agency (LEA)	251300000X	Primary

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