| Winding Waters Wallowa | |
|
605 W Hwy 82 Wallowa OR 97885-8544 | |
| (541) 426-4502 | |
| Not Available |
| Full Name | Winding Waters Wallowa |
|---|---|
| Speciality | Clinic/Center |
| Location | 605 W Hwy 82, Wallowa, Oregon |
| Authorized Official Name and Position | Keli Jean Dennis (COO) |
| Authorized Official Contact | 5414264502 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Winding Waters Wallowa 603 Medical Pkwy Enterprise OR 97828-5124 Ph: (541) 426-4502 | Winding Waters Wallowa 605 W Hwy 82 Wallowa OR 97885-8544 Ph: (541) 426-4502 |
| NPI Number | 1700453396 |
|---|---|
| Provider Enumeration Date | 06/10/2021 |
| Last Update Date | 09/14/2023 |
| Medicare PECOS PAC ID | 8224346713 |
|---|---|
| Medicare Enrollment ID | O20220511002127 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1700453396 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
Wallowa Memorial Medical Clinic - Wallowa Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 211 East 2nd St, Wallowa, OR 97885 Phone: 541-426-7900 | |
Winding Waters Clinic Pc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 203 E First Street, Wallowa, OR 97885 Phone: 541-886-2431 Fax: 541-886-2211 |