| Waterfall Clinic, Incorporated | |
|
93670 Viking Ln North Bend OR 97459-8623 | |
| (541) 756-6232 | |
| (541) 756-6234 |
| Full Name | Waterfall Clinic, Incorporated |
|---|---|
| Speciality | Clinic/Center |
| Location | 93670 Viking Ln, North Bend, Oregon |
| Authorized Official Name and Position | Andrea Trenner (CEO) |
| Authorized Official Contact | 5417566232 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Waterfall Clinic, Incorporated 1890 Waite St Ste 1 North Bend OR 97459-1229 Ph: (541) 756-6232 | Waterfall Clinic, Incorporated 93670 Viking Ln North Bend OR 97459-8623 Ph: (541) 756-6232 |
| NPI Number | 1447889480 |
|---|---|
| Provider Enumeration Date | 04/02/2020 |
| Last Update Date | 04/02/2020 |
| Medicare PECOS PAC ID | 5698740355 |
|---|---|
| Medicare Enrollment ID | O20220708001445 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1447889480 | NPI | - | NPPES |
| 213342 | Medicaid | OR |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
Waterfall Clinic, Incorporated Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1890 Waite St Ste 1, North Bend, OR 97459 Phone: 541-756-6232 | |
Columbiacare Services Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 2345 Marion St, North Bend, OR 97459 Phone: 541-270-0219 | |
Waterfall Clinic Incorporated Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1890 Waite St, Suite 1, North Bend, OR 97459 Phone: 541-756-6232 Fax: 541-756-6234 | |
Icco, Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1226 Virginia Ave, North Bend, OR 97459 Phone: 541-305-4224 Fax: 541-998-4571 | |
Inland Point Senior Estates Jv Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 2265 Inland Drive, North Bend, OR 97459 Phone: 541-756-9740 Fax: 541-756-9739 |