Provider Demographics
NPI:1235232174
Name:WHITE RIVER SCHOOL DISTRICT
Entity Type:Organization
Organization Name:WHITE RIVER SCHOOL DISTRICT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF STUDENT SUPPORT SERVICE
Authorized Official - Prefix:
Authorized Official - First Name:HUGH
Authorized Official - Middle Name:E
Authorized Official - Last Name:FLINT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:360-829-3959
Mailing Address - Street 1:240 NORTH A STREET
Mailing Address - Street 2:PO BOX 2050
Mailing Address - City:BUCKLEY
Mailing Address - State:WA
Mailing Address - Zip Code:98321-2050
Mailing Address - Country:US
Mailing Address - Phone:360-829-3959
Mailing Address - Fax:360-829-3358
Practice Address - Street 1:240 NORTH A STREET
Practice Address - Street 2:
Practice Address - City:BUCKLEY
Practice Address - State:WA
Practice Address - Zip Code:98321-2050
Practice Address - Country:US
Practice Address - Phone:360-829-3959
Practice Address - Fax:360-829-3358
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-06
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
WA7442163Medicaid