Provider Demographics
NPI:1124114384
Name:REGION 9 EDUCATIONAL SERVICE DISTRICT
Entity type:Organization
Organization Name:REGION 9 EDUCATIONAL SERVICE DISTRICT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF SPECIAL EDUCATION
Authorized Official - Prefix:
Authorized Official - First Name:CONNIE
Authorized Official - Middle Name:
Authorized Official - Last Name:MILLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:541-298-5156
Mailing Address - Street 1:400 E SCENIC DR
Mailing Address - Street 2:SUITE #207
Mailing Address - City:THE DALLES
Mailing Address - State:OR
Mailing Address - Zip Code:97058-3456
Mailing Address - Country:US
Mailing Address - Phone:541-298-5156
Mailing Address - Fax:
Practice Address - Street 1:400 E SCENIC DR
Practice Address - Street 2:SUITE #207
Practice Address - City:THE DALLES
Practice Address - State:OR
Practice Address - Zip Code:97058-3456
Practice Address - Country:US
Practice Address - Phone:541-298-5156
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-05
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR007984Medicaid