| Waterfall Clinic Incorporated | |
|
465 Elrod Ave Coos Bay OR 97420 | |
| (541) 756-6232 | |
| (541) 756-6234 |
| Full Name | Waterfall Clinic Incorporated |
|---|---|
| Speciality | Clinic/center - Federally Qualified Health Center (fqhc) |
| Location | 465 Elrod Ave, Coos Bay, 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 Street Suite 1 North Bend OR 97459-3409 Ph: (541) 756-6232 | Waterfall Clinic Incorporated 465 Elrod Ave Coos Bay OR 97420 Ph: (541) 756-6232 |
| NPI Number | 1669067369 |
|---|---|
| Provider Enumeration Date | 03/04/2021 |
| Last Update Date | 03/04/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1669067369 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
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Waterfall Clinic, Incorporated Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 826 S 11th St, Coos Bay, OR 97420 Phone: 541-756-6232 Fax: 541-756-6234 | |
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