MEDICARE: UNION-BAKER ESD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251300000X	Local Education Agency (LEA)

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1952330730
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	UNION-BAKER ESD

Provider Business Mailing Address
First Line	:	10100 N MCALISTER RD
Second Line	:
City	:	LA GRANDE
State	:	OR
Zip	:	97850-8701
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	10100 N MCALISTER RD
Second Line	:
City	:	LA GRANDE
State	:	OR
Zip	:	97850-8701
Country	:	US
Telephone Number	:	541-963-4106
Fax Number	:

Authorized Official
Title or Position	:	BUSINESS MANAGER
Name	:	AMY L JENNINGS
Credential	:
Telephone Number	:	541-975-5608

Provider Enumeration Date	:	07/02/2006
Last Update Date	:	08/22/2020

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Directions to “UNION-BAKER ESD ” Practice Location

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