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WATERFALL CLINIC, INCORPORATED
NPI 1003445032
Clinic/Center - Federally Qualified Health Center (FQHC) in North Bend, OR

Active since April 02, 2020
1890 WAITE ST STE 1, NORTH BEND, OR 97459(541) 756-6232 Get Directions Write a Review

NPPES record last updated: April 2, 2020. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Waterfall Clinic, Incorporated NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

WATERFALL CLINIC, INCORPORATED (NPI 1003445032), doing business as Waterfall Healthy Neighbor Team, is a healthcare organization registered as a federally qualified health center (fqhc) in North Bend, Oregon and active in the NPI registry since April 2020. The organization lists Andrea Trenner, Ceo, as its authorized official.

NPPES Registry Identity

NPI1003445032
Entity TypeOrganization
Primary Taxonomy261QF0400X
Legal Business NameWATERFALL CLINIC, INCORPORATED
Location Address1890 WAITE ST STE 1North Bend, OR 97459-1229
Mailing Address1890 Waite St Ste 1North Bend, OR 97459-1229 · (541) 756-6232
Phone(541) 756-6232
Organization SubpartYes
Authorized OfficialAndrea TrennerCeo · (541) 756-6232
Enumeration DateApril 2, 2020
NPPES CertifiedApril 2, 2020
✔ NPI 1003445032 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · Federally Qualified Health Center (FQHC)Ambulatory Health Care Facilities
Taxonomy Code261QF0400X
1890 WAITE ST STE 1, North Bend, OR 97459
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Other Names 1

Doing Business AsWaterfall Healthy Neighbor Team

Other Identifiers 1

Medicaid213342OR

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MRS. KELLY JEAN SQUIRE-HAMBLET MSOTR/L
Occupational Therapist
1890 WAITE ST STE 1
NORTH BEND, OR 97459
Coos County (541) 756-6232
JENNIFER LYNN HOLLING
Community Health Worker
1890 WAITE ST STE 1
NORTH BEND, OR 97459
Coos County (541) 756-6232
HEATHER ELIZABETH MALCOMB BROOKS
Community Health Worker
1890 WAITE ST STE 1
NORTH BEND, OR 97459
Coos County (541) 756-6232
HANNAH R KIRK
Behavior Technician
1890 WAITE ST STE 1
NORTH BEND, OR 97459
Coos County (541) 756-6232
TAYLOR CLAFLIN
Community Health Worker
1890 WAITE ST STE 1
NORTH BEND, OR 97459
Coos County (541) 756-6232
MRS. EMMA C DAVIS MSN, WHNP-BC, APRN
Nurse Practitioner (Women's Health)
1890 WAITE ST STE 1
NORTH BEND, OR 97459
Coos County (541) 756-6232
JODY K TOLMAN
Community Health Worker
1890 WAITE ST STE 1
NORTH BEND, OR 97459
Coos County (541) 756-6232
LIZETTE YANELLI REYES
Behavior Technician
1890 WAITE ST STE 1
NORTH BEND, OR 97459
Coos County (541) 756-6232

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Waterfall Clinic, Incorporated's NPI number?

The NPI number for Waterfall Clinic, Incorporated is 1003445032. It was assigned to this organization in the NPPES registry on April 2, 2020. The provider is doing business as Waterfall Healthy Neighbor Team.

Where is Waterfall Clinic, Incorporated located?

Waterfall Clinic, Incorporated is located at 1890 Waite St Ste 1, North Bend, OR 97459. The listed phone number is (541) 756-6232.

What is Waterfall Clinic, Incorporated's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Federally Qualified Health Center (FQHC), with taxonomy code 261QF0400X.

When was this NPI record last updated?

The NPPES record for Waterfall Clinic, Incorporated was last updated on April 2, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.