Waterfall Clinic Incorporated
Waterfall Clinic Incorporated is a healthcare organization registered as Federally Qualified Health Center (FQHC) in North Bend, OR, holding Type 2 (organization) NPI 1619915113 since 2006. The authorized official on file is Andrea Trenner, Executive Director/Ceo.
✓ Active NPI ✓ Valid NPI checksum
| NPI | 1619915113 |
|---|---|
| Entity type | Organization (Type 2) |
| Legal business name | Waterfall Clinic Incorporated |
| Other name | <Unavail> |
| Practice address | 1890 WAITE ST, SUITE 1, North Bend, OR, 97459 |
| Phone | 5417566232 |
| Fax | 5417566234 |
| Enumeration date | 2006-06-04 |
| Last updated in NPPES | 2017-06-30 |
Authorized official
| Name | Andrea Trenner |
|---|---|
| Title | Executive Director/Ceo |
| Phone | 5417566232 |
Taxonomy & classification
| Taxonomy code | Specialty | Primary | License | State |
|---|---|---|---|---|
| 261QF0400X | Federally Qualified Health Center (FQHC) | Primary | — | — |
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 227623 | Medicaid | OR | — |
| 213342 | Medicaid | OR | — |
Copy-ready billing details
Provider: Waterfall Clinic Incorporated NPI: 1619915113 Taxonomy: 261QF0400X (Federally Qualified Health Center (FQHC)) Address: 1890 WAITE ST, SUITE 1, North Bend, OR, 97459
Providers at this address
| NPI | Name | Type | Specialty | Location |
|---|---|---|---|---|
| 1316921646 | Innovative Physical Therapy, Inc | Organization | Physical Therapist | North Bend, OR |
| 1932150471 | Cynthia Holmes | Individual | Physician Assistant | North Bend, OR |
| 1780627166 | Maria Maldonado | Individual | Family Nurse Practitioner | North Bend, OR |
| 1114137494 | Gladys Shade | Individual | Clinical Social Worker | North Bend, OR |
| 1518164201 | Astrid Diepenbroek | Individual | Dental Hygienist | North Bend, OR |
| 1891978763 | Judith Randall | Individual | Family Nurse Practitioner | North Bend, OR |
| 1477718419 | Laura Burnside-Mcelligott | Individual | Family Nurse Practitioner | North Bend, OR |
| 1629366216 | Cathleen Delibero | Individual | Mental Health Counselor | North Bend, OR |
Verify this record
Cross-check NPI 1619915113 against the authoritative CMS record: view Waterfall Clinic Incorporated on the official NPPES registry .
What is an NPI number?
A National Provider Identifier (NPI) is a unique 10-digit number that CMS assigns to every U.S. healthcare provider and organization under HIPAA. Type 1 NPIs identify individual providers; Type 2 NPIs identify organizations. The NPI appears on insurance claims, prescriptions, and credentialing paperwork, and never changes — even if the provider moves or changes specialty. Read the full guide or validate an NPI number.
Frequently asked questions
How current is this record?
Where is Waterfall Clinic Incorporated located?
Source: CMS NPPES (public data). Snapshot 2026-07-11. Provider record last updated 2017-06-30.