Provider Demographics
NPI:1669694626
Name:DAYTON SCHOOL DISTRICT 2
Entity type:Organization
Organization Name:DAYTON SCHOOL DISTRICT 2
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAID ASSISTANT
Authorized Official - Prefix:MRS
Authorized Official - First Name:DIANNE
Authorized Official - Middle Name:
Authorized Official - Last Name:MCKINLEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:509-382-4775
Mailing Address - Street 1:614 S 3RD ST
Mailing Address - Street 2:
Mailing Address - City:DAYTON
Mailing Address - State:WA
Mailing Address - Zip Code:99328-1562
Mailing Address - Country:US
Mailing Address - Phone:509-382-4775
Mailing Address - Fax:509-382-2081
Practice Address - Street 1:614 S 3RD ST
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:WA
Practice Address - Zip Code:99328-1562
Practice Address - Country:US
Practice Address - Phone:509-382-4775
Practice Address - Fax:509-382-2081
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-02
Last Update Date:2007-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA7441553Medicaid