Healthcare Provider Details

I. General information

NPI: 1053242024
Provider Name (Legal Business Name): ABBY MANRING
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/27/2026
Last Update Date: 05/27/2026
Certification Date: 05/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2205 NW SHEVLIN PARK RD
BEND OR
97703-7195
US

IV. Provider business mailing address

1404 NW KINGSTON AVE UNIT B
BEND OR
97703-2132
US

V. Phone/Fax

Practice location:
  • Phone: 541-678-5698
  • Fax:
Mailing address:
  • Phone: 919-608-3104
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number31162
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: