Provider Demographics
NPI:1922197771
Name:UNION GAP SCHOOL DISTRICT
Entity type:Organization
Organization Name:UNION GAP SCHOOL DISTRICT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:TARA
Authorized Official - Middle Name:JO
Authorized Official - Last Name:SANTUCCI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:509-248-3966
Mailing Address - Street 1:3201 S 4TH STREET
Mailing Address - Street 2:
Mailing Address - City:UNION GAP
Mailing Address - State:WA
Mailing Address - Zip Code:98903-1825
Mailing Address - Country:US
Mailing Address - Phone:509-248-3966
Mailing Address - Fax:509-575-1876
Practice Address - Street 1:3200 2ND ST
Practice Address - Street 2:
Practice Address - City:UNION GAP
Practice Address - State:WA
Practice Address - Zip Code:98903-1825
Practice Address - Country:US
Practice Address - Phone:509-248-3966
Practice Address - Fax:509-575-1876
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-12
Last Update Date:2024-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA251300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA7441256Medicaid