Organization · Type 2 NPI

Winding Waters Medical Clinic

Federally Qualified Health Center (FQHC) · Wallowa, OR

NPI number 1700453396 Active

Practice location

605 W Hwy 82
Wallowa, OR 97885-8544

Call (541) 426-4502 Map

Mailing address

603 Medical Pkwy
Enterprise, OR 97828-5124

Specialties and licenses

Taxonomy	Code	License
Federally Qualified Health Center (FQHC) Primary	261QF0400X	None listed

Federally Qualified Health Center (FQHC): Definition to come...

Another provider at this address

Winding Waters Medical ClinicCommunity/Retail Pharmacy Wallowa, OR NPI 1114631322

NPI record

NPI: 1700453396
Entity type: Organization (Type 2)
Issued: Jun 10, 2021
Last updated: Sep 14, 2023
Status: Active
Subpart: Yes of Winding Waters Medical Clinic

Other names

<unavail>
Winding Waters Wallowa · doing business as
Winding Waters Wallowa · doing business as

Authorized official

Keli Jean Dennis
COO
(541) 426-4502

Verify this record

This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

Is this your record? How to update it.

About NPI 1700453396

Winding Waters Medical Clinic's National Provider Identifier is 1700453396, issued on Jun 10, 2021. The primary taxonomy on file is Federally Qualified Health Center (FQHC) (261QF0400X), and the practice location is in Wallowa, OR. The record was last updated on Sep 14, 2023.