Kelly Andrea Manz

Primary specialty

Psychiatric/Mental Health Registered NurseTaxonomy code 163WP0808X

License

201901765RN Issued in OR

Practice address

1592 Monroe St
North Bend, OR 97459-3657

Phone

(541) 756-2048

Fax

(541) 756-2058

NPI assigned

Dec 17, 2019

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Columbiacare Services

  • Psychiatric Residential Treatment Facility
  • North Bend, OR
  • NPI 1386787596
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1576540800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1763856000000",
    "number": "1043858400",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3587 HEATHROW WAY",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975044004",
            "telephone_number": "541-858-8170",
            "fax_number": "541-858-8164"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1592 MONROE ST",
            "city": "NORTH BEND",
            "state": "OR",
            "postal_code": "974593657",
            "telephone_number": "541-756-2048",
            "fax_number": "541-756-2058"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1201 S Proctor St",
            "address_purpose": "LOCATION",
            "city": "Tacoma",
            "state": "WA",
            "postal_code": "984052047",
            "country_code": "US",
            "telephone_number": "253-396-5935",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MANZ",
        "first_name": "KELLY",
        "middle_name": "ANDREA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-12-17",
        "last_updated": "2025-11-23",
        "certification_date": "2025-11-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "163WP0808X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health",
            "state": "OR",
            "license": "201901765RN",
            "primary": true
        },
        {
            "code": "163WP0807X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health, Child & Adolescent",
            "state": "WA",
            "license": "61316286",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Howard Magill
• Andrea Maine
• Maria G. Maldonado, F.N.P.
• Susan Mallon, QMHA, BA
• Coletta Jean Manske
• Marka Turner, LCSW, LCC
• Alicia Rodriguez Marroquin, R.N., MA, CNS, PHD
• Regina D Martin
• Zachary Martin
• Tera Lei Martinez

• Psychiatric/Mental Health Registered Nurse in North Bend, OR
• Providers in North Bend, OR by specialty
• Psychiatric/Mental Health Registered Nurse in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 23, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.