1235553348 NPI number — MARYSVILLE SCHOOL DISTRICT

Table of content: (NPI 1235553348)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1235553348 NPI number — MARYSVILLE SCHOOL DISTRICT

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
MARYSVILLE SCHOOL DISTRICT
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1235553348
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
02/10/2014
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
4220 80TH STREET NE
Provider Second Line Business Mailing Address:
MARYSVILLE SCHOOL DISTRICT
Provider Business Mailing Address City Name:
MARYSVILLE
Provider Business Mailing Address State Name:
WA
Provider Business Mailing Address Postal Code:
98270
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
360-653-7058
Provider Business Mailing Address Fax Number:
360-657-6824

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
4220 80TH STREET NE
Provider Second Line Business Practice Location Address:
MARYSVILLE SCHOOL DISTRICT
Provider Business Practice Location Address City Name:
MARYSVILLE
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98270
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
360-653-7058
Provider Business Practice Location Address Fax Number:
360-657-6824
Provider Enumeration Date:
02/10/2014

Additional Information

Authorized Official

Authorized Official Last Name:
SUCHAN TOOTHAKER
Authorized Official First Name:
TRACY
Authorized Official Middle Name:
Authorized Official Title or Position:
DIRECTOR OF SPECIAL ED SVCS
Authorized Official Telephone Number:
360-653-0825

Provider Taxonomy Codes

  • Taxonomy code: 235Z00000X , with the licence number:  350661E , registered in the state of WA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 235Z00000X , with the licence number: LL60432328 , registered in the state of WA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)





Copyright © 2007-2025 www.npivalidator.com