# WINDING WATERS MEDICAL CLINIC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** WINDING WATERS MEDICAL CLINIC
- **Other names:** Wallowa Pharmacy of Winding Waters
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1114631322
- **Legal business name:** WINDING WATERS MEDICAL CLINIC
- **Authorized official:** KELI JEAN DENNIS (AUTHORIZED OFFICIAL)
- **Authorized official phone:** (541) 426-4502

## Contact information

- **Practice address:** 605 W HWY 82, WALLOWA, OR 97885-7114
- **Practice address phone:** (541) 426-4502
- **Mailing address:** 603 MEDICAL PKWY, ENTERPRISE, OR 97828-5124
- **Mailing address phone:** (541) 426-4502

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3336C0003X | Community/Retail Pharmacy | — | NULL | Yes |

## Other

- **Enumeration date:** 01/11/2023
- **Last updated:** 09/13/2023