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Organization
WATERFALL CLINIC INCORPORATED
Active
Organization
WATERFALL CLINIC INCORPORATED
Active
Parent organization
WATERFALL CLINIC INCORPORATED
Organization subpart
Yes
Provider details
NPI number
Legal business name
WATERFALL CLINIC INCORPORATED
Authorized official
ANDREA TRENNER (CEO)
(541) 435-7000
Entity
Organization
Contact information
Practice address
1890 WAITE ST STE 1, NORTH BEND, OR 97459-1229
(541) 435-7033
Mailing address
1890 WAITE ST STE 1, NORTH BEND, OR 97459-1229
(541) 435-7033
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
02/27/2018
Last updated
01/13/2019
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