WATERFALL CLINIC, INCORPORATED (NPI# 1508133299) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1508133299 |
| Entity Type | Organization |
| Organization Name | WATERFALL CLINIC, INCORPORATED |
| Practice Address |
826 S 11th St Coos Bay OR 97420 |
| Mailing Address |
1890 Waite St Ste 1 North Bend OR 97459-1229 |
| Practice Telephone | 5417566232 |
| Practice Fax Number | 5417566234 |
| Mailing Telephone | 5417566232 |
| Mailing Fax Number | 5417566234 |
| Enumeration Date | 2011-11-23 |
| Last Update Date | 2018-02-26 |
| Authorized Official Name | AVA KATHLEEN MCFERON (CEO ASST.) |
| Authorized Official Telephone | 5414357033 |
| Is Organization Subpart | Y |
| Parent Organization Name | WATERFALL CLINIC, INCORPORATED |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QF0400X |
Clinic/Center Specialization: Federally Qualified Health Center (FQHC) |
Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OR | 500647633 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003445032 | Waterfall Clinic, Incorporated | Clinic/Center | 1890 Waite St Ste 1, North Bend, OR 97459-1229 | 2020-04-02 |
| 1447889480 | Waterfall Clinic, Incorporated | Clinic/Center | 93670 Viking Ln, North Bend, OR 97459-8623 | 2020-04-02 |
| 1437654779 | Waterfall Clinic, Incorporated | Community/Behavioral Health | 1890 Waite St Ste 1, North Bend, OR 97459-1229 | 2018-03-28 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Oregon Corporations, Companies and Business Names | WATERFALL CLINIC, INCORPORATED | 1890 Waite St Ste 1, North Bend, OR 97459 |
| Street Address |
826 S 11TH ST |
| City | COOS BAY |
| State | OR |
| Zip Code | 97420 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346880606 | Danielle Goette | Massage Therapist | 320 Central Ave Suite 226, Coos Bay, OR 97420 | 2020-01-14 |
| 1730643735 | Nicole Hand-therapeutic Massage | Massage Therapist | 3229 Broadway Avenue, Suite D, Coos Bay, OR 97420 | 2019-01-24 |
| 1528531100 | A Better Reality | Clinic/Center | 2690 N. 17th Sstreet, Coos Bay, OR 97420 | 2019-01-07 |
| 1396216883 | Elizabeth Rose Stephens | Health Educator | 97381 Newport Lane, Coos Bay, OR 97420 | 2018-12-10 |
| 1093263386 | Megan Smith | Physician Assistant | 375 Park Ave Ste 5, Coos Bay, OR 97420 | 2016-09-14 |
| 1285091884 | Richard T Rigney | Counselor | 62754 Karl Road, Coos Bay, OR 97420 | 2016-01-27 |
| 1821493032 | James Thomas Agee | Pharmacist | 2051 Newmark Avenue, Walmart Pharmacy 1880, Coos Bay, OR 97420 | 2014-10-30 |
| 1346663895 | Steven D. Richardson D.m.d. L.l.c | Dentist | 1835 Ocean Blvd Se, Coos Bay, OR 97420 | 2014-02-03 |
| 1144669243 | Michael Jason Cole | Pharmacist | 1020 South First Ave, Coos Bay, OR 97420 | 2013-06-21 |
| 1639518053 | Jonathan Thomas Small | Physical Therapist | 2645 North 17th St, Coos Bay, OR 97420 | 2013-06-19 |
| Find all providers in zip 97420 | ||||
| Taxonomy Code | 261QF0400X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Federally Qualified Health Center (FQHC) |
| Definition to come... |
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|---|---|---|---|---|
| 1215540398 | La Clinica Del Valle Family Healthcare Center Inc. | Clinic/Center | 102 Christian Avenue, Talent, OR 97540 | 2020-08-28 |
| 1790398048 | La Clinica Del Valle Family Healthcare Center Inc. | Clinic/Center | 307 Wagner Creek Road, Talent, OR 97540 | 2020-08-26 |
| 1922656289 | Clackamas County | Clinic/Center | 39831 Highway 26, Sandy, OR 97055-6558 | 2019-08-29 |
| 1063067312 | Virginia Garcia Memorial Health Center | Clinic/Center | 11300 Sw Hazelbrook Rd, Tualatin, OR 97062-6980 | 2019-08-05 |
| 1417411505 | Klamath Health Partnership, Inc | Clinic/Center | 2210 N Eldorado Ave Ste A, Klamath Falls, OR 97601-6418 | 2019-01-23 |
| 1679053946 | Siskiyou Community Health Center Inc | Clinic/Center | 830 Ne 9th St, Grants Pass, OR 97526-1626 | 2018-08-16 |
| 1427563733 | Central City Concern Inc | Clinic/Center | 1415 Se 122nd Ave, Portland, OR 97233 | 2017-12-08 |
| 1598284242 | Winding Waters Medical Clinic | Clinic/Center | 401b N Main St, Joseph, OR 97846-5030 | 2017-09-13 |
| 1750807111 | La Clinica Del Valle Family Health Care Center Inc. | Clinic/Center | 821 N Riverside Ave, Medford, OR 97501 | 2017-08-17 |
| 1477005619 | Outside In | Clinic/Center | 1226 Sw 12th Ave, Portland, OR 97205-2029 | 2016-11-03 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.