Provider Demographics
NPI:1043322647
Name:PUYALLUP SCHOOL DISTRICT
Entity type:Organization
Organization Name:PUYALLUP SCHOOL DISTRICT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR SPECIAL SERVICES
Authorized Official - Prefix:MRS
Authorized Official - First Name:CHRYS
Authorized Official - Middle Name:
Authorized Official - Last Name:SWEETING
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:253-841-8700
Mailing Address - Street 1:214 W MAIN
Mailing Address - Street 2:PO BOX 370
Mailing Address - City:PUYALLUP
Mailing Address - State:WA
Mailing Address - Zip Code:98371-5328
Mailing Address - Country:US
Mailing Address - Phone:253-841-8700
Mailing Address - Fax:253-841-8655
Practice Address - Street 1:214 W MAIN
Practice Address - Street 2:
Practice Address - City:PUYALLUP
Practice Address - State:WA
Practice Address - Zip Code:98371-5328
Practice Address - Country:US
Practice Address - Phone:253-841-8700
Practice Address - Fax:253-841-8655
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-31
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
WA7440688Medicaid