Provider Demographics
NPI:1740906528
Name:WALLOWA SCHOOL DISTRICT #12
Entity type:Organization
Organization Name:WALLOWA SCHOOL DISTRICT #12
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SUPERINTENDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:TAMERA
Authorized Official - Middle Name:
Authorized Official - Last Name:JONES
Authorized Official - Suffix:
Authorized Official - Credentials:EDD
Authorized Official - Phone:425-315-6777
Mailing Address - Street 1:PO BOX 425
Mailing Address - Street 2:
Mailing Address - City:WALLOWA
Mailing Address - State:OR
Mailing Address - Zip Code:97885-0425
Mailing Address - Country:US
Mailing Address - Phone:541-866-7355
Mailing Address - Fax:
Practice Address - Street 1:315 E 1ST ST
Practice Address - Street 2:
Practice Address - City:WALLOWA
Practice Address - State:OR
Practice Address - Zip Code:97885-0425
Practice Address - Country:US
Practice Address - Phone:541-866-7355
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-10-13
Last Update Date:2022-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)