Organization
SHIFT BEND FUNCTIONAL MEDICINE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARIE AGNEW FNP-C, DNP (OWNER AND MEDICAL PROVIDER)
(541) 219-1910
Entity
Organization
Contact information
Practice address
151 SW SHEVLIN HICKS DR, SUITE #1, BEND, OR 97702
(541) 219-1910
Mailing address
556 NW TRENTON AVE, BEND, OR 97703-1126
(541) 219-1910
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Enumeration date
12/26/2019
Last updated
12/26/2019
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