Provider Demographics
NPI:1619453560
Name:WASCO COUNTY SCHOOL DISTRICT 29
Entity Type:Organization
Organization Name:WASCO COUNTY SCHOOL DISTRICT 29
Other - Org Name:DUFUR SCHOOL DISTRICT
Other - Org Type:Other Name
Authorized Official - Title/Position:SUPERINTENDENT
Authorized Official - Prefix:
Authorized Official - First Name:JACK
Authorized Official - Middle Name:
Authorized Official - Last Name:HENDERSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:541-467-2509
Mailing Address - Street 1:802 NE 5TH STREET
Mailing Address - Street 2:
Mailing Address - City:DUFUR
Mailing Address - State:OR
Mailing Address - Zip Code:97021
Mailing Address - Country:US
Mailing Address - Phone:541-467-2509
Mailing Address - Fax:541-467-2589
Practice Address - Street 1:802 NE 5TH STREET
Practice Address - Street 2:
Practice Address - City:DUFUR
Practice Address - State:OR
Practice Address - Zip Code:97021
Practice Address - Country:US
Practice Address - Phone:541-467-2509
Practice Address - Fax:541-467-2589
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-07-13
Last Update Date:2018-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR033709Medicaid