=====================================================
General NPI Number Information
=====================================================
NPI Number | 1356267652
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | ONTARIO SCHOOL DISTRICT 8C
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/29/2026
-----------------------------------------------------
Last Update Date | 06/29/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 195 SW 3RD AVE
-----------------------------------------------------
City | ONTARIO
-----------------------------------------------------
State | OR
-----------------------------------------------------
Zip | 97914-2723
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 541-889-5374
-----------------------------------------------------
Fax | 541-889-8553
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 195 SW 3RD AVE
-----------------------------------------------------
City | ONTARIO
-----------------------------------------------------
State | OR
-----------------------------------------------------
Zip | 97914-2723
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 541-889-5374
-----------------------------------------------------
Fax | 541-889-8553
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | MEDICAID COORDINATOR
-----------------------------------------------------
Name | LISA MAEDA
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 541-889-5374
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 163WS0200X
-----------------------------------------------------
Taxonomy Name | School Registered Nurse
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------