Healthcare Provider Details

I. General information

NPI: 1356267652
Provider Name (Legal Business Name): ONTARIO SCHOOL DISTRICT 8C
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/29/2026
Last Update Date: 06/29/2026
Certification Date: 06/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

195 SW 3RD AVE
ONTARIO OR
97914-2723
US

IV. Provider business mailing address

195 SW 3RD AVE
ONTARIO OR
97914-2723
US

V. Phone/Fax

Practice location:
  • Phone: 541-889-5374
  • Fax: 541-889-8553
Mailing address:
  • Phone: 541-889-5374
  • Fax: 541-889-8553

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WS0200X
TaxonomySchool Registered Nurse
License Number
License Number State

VIII. Authorized Official

Name: LISA MAEDA
Title or Position: MEDICAID COORDINATOR
Credential:
Phone: 541-889-5374