Organization
WATERFALL CLINIC INCORPORATED
Active
Other names
Waterfall Community Health Center
Organization subpart
No
Provider details
NPI number
Authorized official
ANDREA TRENNER (CEO)
(541) 756-6232
Entity
Organization
Contact information
Practice address
400 FIR AVE, POWERS, OR 97466
(541) 756-6232
(541) 756-6234
Mailing address
1890 WAITE ST, STE 1, NORTH BEND, OR 97459-1229
(541) 756-6232
(541) 756-6234
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500642717
—
OR
Enumeration date
10/19/2011
Last updated
02/26/2018
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