Provider Demographics
NPI:1154565190
Name:UMATILLA-MORROW ESD
Entity type:Organization
Organization Name:UMATILLA-MORROW ESD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SUPERINTENDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MARK
Authorized Official - Middle Name:
Authorized Official - Last Name:MULVIHILL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:541-966-3102
Mailing Address - Street 1:2001 SW NYE AVE
Mailing Address - Street 2:
Mailing Address - City:PENDLETON
Mailing Address - State:OR
Mailing Address - Zip Code:97801-4416
Mailing Address - Country:US
Mailing Address - Phone:541-966-3100
Mailing Address - Fax:541-276-4245
Practice Address - Street 1:2001 SW NYE AVE
Practice Address - Street 2:
Practice Address - City:PENDLETON
Practice Address - State:OR
Practice Address - Zip Code:97801-4416
Practice Address - Country:US
Practice Address - Phone:541-966-3100
Practice Address - Fax:541-276-4245
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-04-21
Last Update Date:2009-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR500606470Medicaid