Healthcare Provider Details

I. General information

NPI: 1154239192
Provider Name (Legal Business Name): GRANT COUNTY SCHOOL DISTRICT #4
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/31/2026
Last Update Date: 08/31/2026
Certification Date: 08/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

740 S OVERHOLT ST
PRAIRIE CITY OR
97869-2145
US

IV. Provider business mailing address

PO BOX 345
PRAIRIE CITY OR
97869-0345
US

V. Phone/Fax

Practice location:
  • Phone: 844-820-3314
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251300000X
TaxonomyLocal Education Agency (LEA)
License Number
License Number State

VIII. Authorized Official

Name: EMMA WINKELMAN
Title or Position: BUSINESS MANAGER
Credential:
Phone: 541-575-4071