Provider Demographics
NPI:1124132097
Name:WALLA WALLA PUBLIC SCHOOLS
Entity type:Organization
Organization Name:WALLA WALLA PUBLIC SCHOOLS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF SPECIAL EDUCATION
Authorized Official - Prefix:MRS
Authorized Official - First Name:LIBBY
Authorized Official - Middle Name:L
Authorized Official - Last Name:THOMPSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:509-526-6727
Mailing Address - Street 1:364 S PARK ST
Mailing Address - Street 2:
Mailing Address - City:WALLA WALLA
Mailing Address - State:WA
Mailing Address - Zip Code:99362-3249
Mailing Address - Country:US
Mailing Address - Phone:509-526-6724
Mailing Address - Fax:509-529-7713
Practice Address - Street 1:364 S PARK ST
Practice Address - Street 2:
Practice Address - City:WALLA WALLA
Practice Address - State:WA
Practice Address - Zip Code:99362-3249
Practice Address - Country:US
Practice Address - Phone:509-526-6724
Practice Address - Fax:509-529-7713
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-18
Last Update Date:2016-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA251300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA7441181Medicaid