| Waterfall Clinic Incorporated | |
|
400 Fir Ave Powers OR 97466 | |
| (541) 756-6232 | |
| (541) 756-6234 |
| Full Name | Waterfall Clinic Incorporated |
|---|---|
| Speciality | Clinic/center - Federally Qualified Health Center (fqhc) |
| Location | 400 Fir Ave, Powers, Oregon |
| Authorized Official Name and Position | Andrea Trenner (CEO) |
| Authorized Official Contact | 5417566232 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| 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 400 Fir Ave Powers OR 97466 Ph: (541) 756-6232 |
| NPI Number | 1609151810 |
|---|---|
| Provider Enumeration Date | 10/19/2011 |
| Last Update Date | 02/26/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1609151810 | NPI | - | NPPES |
| 500642717 | Medicaid | OR |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |