Provider Demographics
NPI:1215966007
Name:BOISTFORT SCHOOL DISTRICT
Entity type:Organization
Organization Name:BOISTFORT SCHOOL DISTRICT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR, LEWIS CO. SP. ED. CO-OP
Authorized Official - Prefix:
Authorized Official - First Name:REBECCA
Authorized Official - Middle Name:J
Authorized Official - Last Name:TURNBULL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:360-748-3384
Mailing Address - Street 1:983 BOISTFORT RD
Mailing Address - Street 2:
Mailing Address - City:CURTIS
Mailing Address - State:WA
Mailing Address - Zip Code:98538-9734
Mailing Address - Country:US
Mailing Address - Phone:360-245-3343
Mailing Address - Fax:
Practice Address - Street 1:983 BOISTFORT RD
Practice Address - Street 2:
Practice Address - City:CURTIS
Practice Address - State:WA
Practice Address - Zip Code:98538-9734
Practice Address - Country:US
Practice Address - Phone:360-245-3343
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-02
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
WA7440456Medicaid