Healthcare Provider Details

I. General information

NPI: 1811160385
Provider Name (Legal Business Name): AMANDA RAE MUNK M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/07/2008
Last Update Date: 09/28/2026
Certification Date: 09/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2500 NE NEFF RD
BEND OR
97701-6015
US

IV. Provider business mailing address

65158 HUNNELL RD
BEND OR
97703-8136
US

V. Phone/Fax

Practice location:
  • Phone: 541-382-4321
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberMD151089
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: