Brendan Gordon Tennefoss (NPI# 1528571130, PAC ID# 4880951391) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is NURSE PRACTITIONER.
| Nation Provider ID (NPI) | 1528571130 |
| PAC ID by PECOS | 4880951391 |
| Professional Enrollment ID | I20171207002046 |
| Full Name | Brendan Gordon Tennefoss |
| Organization Legal Name | WATERFALL CLINIC INCORPORATED |
| Address |
826 S 11th St Coos Bay OR 97420-1328 |
| Phone Number | 5412671495 |
| Gender | M |
| Graduation Year | 2017 |
| Primary Specialty | NURSE PRACTITIONER |
| Group Practice PAC ID | 5698740355 |
| Number of Group Practice Members | 7 |
| Accepts Medicare Assignment | M |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 380090 | BAY AREA HOSPITAL |
| Address | Phone | Organization |
|---|---|---|
| 826 S 11th St, Coos Bay, OR 97420-1328 | 5412671495 | WATERFALL CLINIC INCORPORATED |
| 1890 Waite St, Suite 1, North Bend, OR 97459-1229 | 5414357033 | WATERFALL CLINIC INCORPORATED |
| Organization Legal Name | WATERFALL CLINIC INCORPORATED |
| Physicians | 18 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Ronald M St Jean | Clinical Social Worker | Waterfall Clinic Incorporated | 1950 Waite St, North Bend, OR 97459-1228 |
| Shirley D Reynolds | Nurse Practitioner | Waterfall Clinic Incorporated | 1890 Waite St, Suite 1, North Bend, OR 97459-1229 |
| Shu-wen Cheng | Nurse Practitioner | Waterfall Clinic Incorporated | 826 S 11th St, Coos Bay, OR 97420-1328 |
| Pernilla Johansson | Clinical Social Worker | Waterfall Clinic Incorporated | 1890 Waite St, North Bend, OR 97459-1229 |
| Denise J Gontiz | Nurse Practitioner | Waterfall Clinic Incorporated | 826 S 11th St, Coos Bay, OR 97420-1328 |
| David W Walker | Nurse Practitioner | Waterfall Clinic Incorporated | 1890 Waite St, North Bend, OR 97459-1229 |
| Pei J Purdom | Nurse Practitioner | Waterfall Clinic Incorporated | 1890 Waite St, Suite 1, North Bend, OR 97459-1229 |
| Yvonne L Fenrich | Nurse Practitioner | Waterfall Clinic Incorporated | 1890 Waite St, Suite 1, North Bend, OR 97459-1229 |
| Toyin A Akanni | Nurse Practitioner | Waterfall Clinic Incorporated | 1890 Waite St, North Bend, OR 97459-1229 |
| Michael Huck | Clinical Social Worker | Waterfall Clinic Incorporated | 1890 Waite St, Suite 1, North Bend, OR 97459-1229 |
| Street Address |
826 S 11TH ST |
| City | COOS BAY |
| State | OR |
| Zip | 97420-1328 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Shu-wen Cheng | Nurse Practitioner | Waterfall Clinic Incorporated | 826 S 11th St, Coos Bay, OR 97420-1328 |
| Denise J Gontiz | Nurse Practitioner | Waterfall Clinic Incorporated | 826 S 11th St, Coos Bay, OR 97420-1328 |
| Debra Sue Guzman | Nurse Practitioner | Waterfall Clinic Incorporated | 826 S 11th St, Coos Bay, OR 97420-1328 |
| Emily E Scotland | Nurse Practitioner | Waterfall Clinic Incorporated | 826 S 11th St, Coos Bay, OR 97420-1328 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Abby L Stauss | Chiropractic | Dianna Loudenbeck Dc PC | 576 Donnelly Ave, Coos Bay, OR 97420-1555 |
| Dianna L Loudenbeck | Chiropractic | Dianna Loudenbeck Dc PC | 576 Donnelly Ave, Coos Bay, OR 97420-1555 |
| Edward L Lanway | Chiropractic | 632 Anderson Ave, Coos Bay, OR 97420-1632 | |
| Patricia B Gates | Optometry | 986 Central Ave, Coos Bay, OR 97420-1736 | |
| Mirian W Groenendaal | Physical Therapy | Starting Line Physical Therapy | 1957 Thompson Rd, Suite A, Coos Bay, OR 97420-2040 |
| Paul S Koh | Undefined Physician Type (specify) | Peacehealth | 1975 Thompson Rd, Suite F, Coos Bay, OR 97420-2040 |
| Juliette L Hyatt | Physical Therapy | Starting Line Physical Therapy | 1957 Thompson Rd, Suite A, Coos Bay, OR 97420-2040 |
| Matthew R Trojan | Cardiovascular Disease (cardiology) | Peacehealth | 1975 Thompson Rd, Suite F, Coos Bay, OR 97420-2040 |
| Ashok Venkataraman | Cardiac Surgery | Peacehealth | 1975 Thompson Rd, Suite F, Coos Bay, OR 97420-2040 |
| Annalissa Martins | Physical Therapy | Starting Line Physical Therapy | 1957 Thompson Rd, Suite A, Coos Bay, OR 97420-2040 |
| Find all physicians in zip 97420 | |||
| City | COOS BAY |
| Zip Code | 97420 |
| Specialty | NURSE PRACTITIONER |
| City + Specialty | COOS BAY + NURSE PRACTITIONER |
Please comment or provide details below to improve the information on Brendan Gordon Tennefoss.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.