NPIMap

Organization Active NPI

Waterfall Clinic, Incorporated

  • Community/Behavioral Health Agency
  • North Bend, OR
National Provider Identifier
1437654779
Registry record updated Jun 11, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
WATERFALL CLINIC, INCORPORATED
Practice address
1890 Waite St Ste 1
North Bend, OR 97459-1229
Phone
(541) 435-7033
NPI assigned
Mar 28, 2018
Last updated
Jun 11, 2019By the provider in NPPES
Organization subpart
Yes
Parent organization
WATERFALL CLINIC, INCORPORATEDAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jun 11, 2019

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Andrea Trenner
Title
Ceo
Phone
(541) 435-7000

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X Primary

Addresses

Primary practice location

1890 Waite St Ste 1
North Bend, OR 97459-1229

Mailing address

1890 Waite St Ste 1
North Bend, OR 97459-1229
Phone (541) 435-7033

National Provider Directory

National Provider Directory
Tax ID family
Waterfall Community Health Center8 organizations share this tax ID, including this one
Part of
Waterfall Community Health Center

Other organizations with this tax ID 7

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1522195200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1560211200000",
    "number": "1437654779",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1890 WAITE ST STE 1",
            "city": "NORTH BEND",
            "state": "OR",
            "postal_code": "974591229",
            "telephone_number": "541-435-7033"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1890 WAITE ST STE 1",
            "city": "NORTH BEND",
            "state": "OR",
            "postal_code": "974591229",
            "telephone_number": "541-435-7033"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WATERFALL CLINIC, INCORPORATED",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "WATERFALL CLINIC, INCORPORATED",
        "enumeration_date": "2018-03-28",
        "last_updated": "2019-06-11",
        "status": "A",
        "authorized_official_last_name": "TRENNER",
        "authorized_official_first_name": "ANDREA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "541-435-7000"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in North Bend, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.