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Organization
ROOTS FAMILY MEDICINE LLC
Active
Organization
ROOTS FAMILY MEDICINE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. SHANNA GEIGLE NP (OWNER)
(503) 475-9650
Entity
Organization
Contact information
Practice address
2275 NE DOCTORS DR STE 1A, BEND, OR 97701
(541) 241-2656
(541) 241-9848
Mailing address
2275 NE DOCTORS DR STE 1A, BEND, OR 97701-6324
(541) 241-2656
(541) 241-9848
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
NULL
207Q00000X
Family Medicine Physician
Primary
—
—
207R00000X
Internal Medicine Physician
—
NULL
207R00000X
Internal Medicine Physician
—
—
208D00000X
General Practice Physician
—
NULL
208D00000X
General Practice Physician
—
—
363L00000X
Nurse Practitioner
—
NULL
363L00000X
Nurse Practitioner
—
—
363LF0000X
Family Nurse Practitioner
—
NULL
363LF0000X
Family Nurse Practitioner
—
—
363LP2300X
Primary Care Nurse Practitioner
—
NULL
363LP2300X
Primary Care Nurse Practitioner
—
—
363LW0102X
Women's Health Nurse Practitioner
—
NULL
363LW0102X
Women's Health Nurse Practitioner
—
—
Other
Enumeration date
12/09/2018
Last updated
04/08/2019
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