Healthcare Provider Details

I. General information

NPI: 1992830152
Provider Name (Legal Business Name): ALYSSA D ABBEY PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/21/2007
Last Update Date: 03/19/2026
Certification Date: 03/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

255 SW BLUFF DR STE 200
BEND OR
97702-3999
US

IV. Provider business mailing address

255 SW BLUFF DR STE 200
BEND OR
97702-3999
US

V. Phone/Fax

Practice location:
  • Phone: 541-638-8558
  • Fax: 541-797-5033
Mailing address:
  • Phone: 541-638-8558
  • Fax: 541-797-5033

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License NumberPA01225
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: