Organization
RAINIER STATE SCHOOL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
COLLEEN T PECK MD (MEDICAL DIRECTOR)
(425) 301-9856
Entity
Organization
Contact information
Practice address
2120 RYAN RD, BUCKLEY, WA 98321-9115
(360) 829-1111
(360) 829-3088
Mailing address
2120 RYAN RD, BUCKLEY, WA 98321-9115
(360) 829-1111
(360) 829-3088
Taxonomy
Speciality
Code
Description
License number
State
315P00000X
Intellectual Disabilities Intermediate Care Facility
Primary
—
—
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
—
—
Other
Enumeration date
03/20/2007
Last updated
01/03/2023
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