Healthcare Provider Details

I. General information

NPI: 1235224684
Provider Name (Legal Business Name): GRANDVIEW SCHOOL DISTRICT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/03/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

913 W 2ND STREET
GRANDVIEW WA
98930
US

IV. Provider business mailing address

913 W 2ND STREET
GRANDVIEW WA
98930
US

V. Phone/Fax

Practice location:
  • Phone: 509-882-8500
  • Fax: 509-882-2029
Mailing address:
  • Phone: 509-882-8500
  • Fax: 509-882-2029

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: MR. BRADFORD C SHREEVE
Title or Position: ASST. SUPERINTENDENT FOR FINANCE
Credential:
Phone: 509-882-8510