Healthcare Provider Details

I. General information

NPI: 1841385010
Provider Name (Legal Business Name): KIONA-BENTON CITY SCHOOL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/04/2006
Last Update Date: 02/10/2025
Certification Date: 02/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1105 DALE AVE
BENTON CITY WA
99320-8872
US

IV. Provider business mailing address

1105 DALE AVE
BENTON CITY WA
99320-8872
US

V. Phone/Fax

Practice location:
  • Phone: 509-588-2000
  • Fax: 509-588-5580
Mailing address:
  • Phone: 509-588-2000
  • Fax: 509-588-5580

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: CRAIG BAILEY
Title or Position: SPECIAL EDUCATION DIRECTOR
Credential:
Phone: 509-588-2021