Provider Demographics
NPI:1700816766
Name:ENTIAT SCHOOL DISTRICT
Entity Type:Organization
Organization Name:ENTIAT SCHOOL DISTRICT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SUPERINTENDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:DENNIS
Authorized Official - Middle Name:
Authorized Official - Last Name:CHAMBERS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:509-784-1800
Mailing Address - Street 1:2650 ENTIAT WAY
Mailing Address - Street 2:
Mailing Address - City:ENTIAT
Mailing Address - State:WA
Mailing Address - Zip Code:98822-9710
Mailing Address - Country:US
Mailing Address - Phone:509-784-1800
Mailing Address - Fax:509-784-2986
Practice Address - Street 1:2650 ENTIAT WAY
Practice Address - Street 2:
Practice Address - City:ENTIAT
Practice Address - State:WA
Practice Address - Zip Code:98822-9710
Practice Address - Country:US
Practice Address - Phone:509-784-1800
Practice Address - Fax:509-784-2986
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-04
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
WA7440696Medicaid