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Individual

CODY MANRIQUEZ

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
2200 NE NEFF RD STE 200, BEND, OR 97701-4281
(541) 382-3344
(541) 382-1681
Mailing address
2200 NE NEFF RD STE 200, BEND, OR 97701-4281
(541) 382-3344

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
PA197783
LICENSE
OR
Enumeration date
02/10/2020
Last updated
04/02/2025
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