| Organization Name: | EDUCATIONAL SERVICE DISTRICT 113 |
| NPI Number: | 1285886655 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | ROBERT M VINCENT (ADMINISTRATOR) |
| Mailing Address: | 22 Viking Way Raymond |
| State: | WA US |
| Postal Code: | 985779308 |
| Phone Number: | 3609422006 |
| Fax Number: | |
| NPI Enumeration Date: | 10/16/2008 |
| NPI Last Update Date: | 09/24/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QR0405X |
| License Number: | 25143100 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | WA |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Rehabilitation, Substance Use Disorder |
| Taxonomy Definition: | |