Provider Demographics
NPI:1588694533
Name:ELLENSBURG SCHOOL DISTRICT
Entity type:Organization
Organization Name:ELLENSBURG SCHOOL DISTRICT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SUPERINTENDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:GLENEWINKEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:509-925-8000
Mailing Address - Street 1:1300 E 3RD AVE
Mailing Address - Street 2:
Mailing Address - City:ELLENSBURG
Mailing Address - State:WA
Mailing Address - Zip Code:98926-3576
Mailing Address - Country:US
Mailing Address - Phone:509-925-8000
Mailing Address - Fax:509-925-8025
Practice Address - Street 1:1300 E 3RD AVE
Practice Address - Street 2:
Practice Address - City:ELLENSBURG
Practice Address - State:WA
Practice Address - Zip Code:98926-3576
Practice Address - Country:US
Practice Address - Phone:509-925-8000
Practice Address - Fax:509-925-8025
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-04
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
WA7440738Medicaid