Organization
DOUGLAS EDUCATION SERVICE DISTRICT
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANALICIA NICHOLSON (SUPERINTENDENT)
(541) 440-4753
Entity
Organization
Contact information
Practice address
1409 NE DIAMOND LAKE BLVD STE 110, ROSEBURG, OR 97470-3356
(541) 440-4753
Mailing address
1409 NE DIAMOND LAKE BLVD STE 110, ROSEBURG, OR 97470-3356
(541) 440-4753
Taxonomy
Speciality
Code
Description
License number
State
163WS0200X
School Registered Nurse
—
—
235Z00000X
Speech-Language Pathologist
—
—
251300000X
Local Education Agency (LEA)
Primary
—
—
Other
Enumeration date
06/06/2025
Last updated
09/03/2025
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