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) 756-6232
Entity
Organization
Contact information
Practice address
465 ELROD AVE, COOS BAY, OR 97420
(541) 756-6232
(541) 756-6234
Mailing address
1890 WAITE STREET, SUITE 1, NORTH BEND, OR 97459-3409
(541) 756-6232
(541) 756-6234
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Enumeration date
03/04/2021
Last updated
03/04/2021
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