Individual
KELLY ANDREA MANZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1592 MONROE ST, NORTH BEND, OR 97459-3657
(541) 756-2048
(541) 756-2058
Mailing address
3587 HEATHROW WAY, MEDFORD, OR 97504-4004
(541) 858-8170
(541) 858-8164
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
163WP0807X
Child & Adolescent Psychiatric/Mental Health Registered Nurse
61316286
WA
163WP0808X
Psychiatric/Mental Health Registered Nurse
Primary
201901765RN
OR
Other
Enumeration date
12/17/2019
Last updated
11/23/2025
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