| Deep Roots Family Medicine | |
|
605 Union St Ne Salem OR 97301-2462 | |
| (971) 207-3680 | |
| (503) 339-9585 |
| Full Name | Deep Roots Family Medicine |
|---|---|
| Speciality | Naturopath |
| Location | 605 Union St Ne, Salem, Oregon |
| Authorized Official Name and Position | George Gonzales (OWNER) |
| Authorized Official Contact | 5416027096 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Deep Roots Family Medicine 605 Union St Ne Salem OR 97301-2462 Ph: (971) 207-3680 | Deep Roots Family Medicine 605 Union St Ne Salem OR 97301-2462 Ph: (971) 207-3680 |
| NPI Number | 1871013409 |
|---|---|
| Provider Enumeration Date | 06/24/2017 |
| Last Update Date | 07/21/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1871013409 | NPI | - | NPPES |
| 1083864029 | Other | OR | NPPES |
| 1184647398 | Other | OR | NPPES |
| 1902115215 | Other | OR | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | C3986 (Oregon) | Secondary |
| 175F00000X | Naturopath | 1781 (Oregon) | Primary |
| 175F00000X | Naturopath | 00960 (Oregon) | Secondary |
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