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WINDING WATERS CLINIC PC
NPI 1053304394
Clinic/Center - Rural Health in Enterprise, OR

Active since August 23, 2005CLIA 38D0628581 · Waiver
603 MEDICAL PKWY, ENTERPRISE, OR 97828(541) 426-4502(541) 426-6403 Get Directions Write a Review

NPPES record last updated: June 29, 2015. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Winding Waters Clinic Pc NPPES

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

WINDING WATERS CLINIC PC (NPI 1053304394) is a healthcare organization registered as a rural health in Enterprise, Oregon and active in the NPI registry since August 2005. The organization holds a CLIA Waiver certificate valid through August 1, 2027 and lists Renee E Grandi, Pres, as its authorized official.

NPPES Registry Identity

NPI1053304394
Entity TypeOrganization
Primary Taxonomy261QR1300X
Legal Business NameWINDING WATERS CLINIC PC
Location Address603 MEDICAL PKWYEnterprise, OR 97828-5124
Mailing Address603 Medical PkwyEnterprise, OR 97828-5124 · (541) 426-4502 · Fax (541) 426-6403
Phone(541) 426-4502
Fax(541) 426-6403
Organization SubpartNo
Authorized OfficialRenee E GrandiPres · (541) 426-4502
Enumeration DateAugust 23, 2005
Last NPPES UpdateJune 29, 2015
✔ NPI 1053304394 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyClinic/Center · Rural HealthAmbulatory Health Care Facilities
Taxonomy Code261QR1300X
License✔ Licensed in OR · 383864
Also ListedClinic/CenterTaxonomy 261Q00000X
603 MEDICAL PKWY, Enterprise, OR 97828
Open in Google Maps ↗

Other Identifiers 5

Medicare NSC1103330001OR
OtherCG2920OR · Railroad Medicare
Medicaid223198OR
Medicare OSCAR/certification383864OR
OtherOR01145OR · Medicare Emc Submitter

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 38D0628581

Winding Waters Medical Clinic · Enterprise, OR
Active · expires Aug 1, 2027
CLIA Number38D0628581
Laboratory TypeFederally Qualified Health Center
Certificate Effective DateAugust 2, 2025
Certificate Expiration DateAugust 1, 2027
Laboratory DirectorElizabeth Powers
Laboratory Phone(541) 426-4502
Laboratory LocationWinding Waters Medical Clinic603 Medical Parkway, Enterprise, OR 97828
CLIA data matches this NPI record on: Address Phone
This certificate is issued to a laboratory to perform only waived tests.

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.

RANDI MOVICH RN
Registered Nurse
603 MEDICAL PKWY
ENTERPRISE, OR 97828
Wallowa County (541) 426-4502
WESTON BAKER MD
Family Medicine
603 MEDICAL PKWY
ENTERPRISE, OR 97828
Wallowa County (541) 426-4502
NORA THERESA STANGEL
Registered Nurse
603 MEDICAL PKWY
ENTERPRISE, OR 97828
Wallowa County (541) 426-4502
RONALD DUY LE DMD
Dentist
603 MEDICAL PKWY
ENTERPRISE, OR 97828
Wallowa County (503) 998-6598
KELLY GRACE FULLER RDH
Dental Hygienist
603 MEDICAL PKWY
ENTERPRISE, OR 97828
Wallowa County (541) 426-4502
KRISTEN RUCKDASHEL
Behavior Technician
603 MEDICAL PKWY
ENTERPRISE, OR 97828
Wallowa County (541) 426-4502
JENNIFER LITTLE NP
Nurse Practitioner (Family)
603 MEDICAL PKWY
ENTERPRISE, OR 97828
Wallowa County (541) 426-5460
SUSANNE CRANE PA-C
Physician Assistant (Medical)
603 MEDICAL PKWY
ENTERPRISE, OR 97828
Wallowa County (541) 426-4502

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 Winding Waters Clinic PC's NPI number?

The NPI number for Winding Waters Clinic PC is 1053304394. It was assigned to this organization in the NPPES registry on August 23, 2005.

Where is Winding Waters Clinic PC located?

Winding Waters Clinic PC is located at 603 Medical Pkwy, Enterprise, OR 97828. The listed phone number is (541) 426-4502.

What is Winding Waters Clinic PC's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Rural Health, with taxonomy code 261QR1300X.

Does Winding Waters Clinic PC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 38D0628581) is associated with this NPI, valid through August 1, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Winding Waters Clinic PC was last updated on June 29, 2015. NPI Profile syncs with the weekly NPPES data releases published by CMS.