Organization
WATERFALL CLINIC INCORPORATED
Active
Other names
Waterfall Community Health Center
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. ANDREA TRENNER (EXECUTIVE DIRECTOR/CEO)
(541) 756-6232
Entity
Organization
Contact information
Practice address
1890 WAITE ST, SUITE 1, NORTH BEND, OR 97459-1229
(541) 756-6232
(541) 756-6234
Mailing address
1890 WAITE ST, SUITE 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
—
213342
—
OR
05
—
227623
—
OR
Enumeration date
06/04/2006
Last updated
06/30/2017
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