| Waterfall Clinic Incorporated | |
|
1890 Waite St Ste 1 North Bend OR 97459-1229 | |
| (541) 435-7033 | |
| Not Available |
| Full Name | Waterfall Clinic Incorporated |
|---|---|
| Speciality | Counselor |
| Location | 1890 Waite St Ste 1, North Bend, Oregon |
| Authorized Official Name and Position | Andrea Trenner (CEO) |
| Authorized Official Contact | 5414357000 |
| 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) 435-7033 | Waterfall Clinic Incorporated 1890 Waite St Ste 1 North Bend OR 97459-1229 Ph: (541) 435-7033 |
| NPI Number | 1851892509 |
|---|---|
| Provider Enumeration Date | 02/27/2018 |
| Last Update Date | 01/13/2019 |
| Medicare PECOS PAC ID | 5698740355 |
|---|---|
| Medicare Enrollment ID | O20180516002844 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1851892509 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
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