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Organization
P. BONEBRAKE MD CHILD AND ADOLESCENT PSYCHIATRY LLC
Active
Organization
P. BONEBRAKE MD CHILD AND ADOLESCENT PSYCHIATRY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PORTIA BONEBRAKE M.D. (SOLE MEMBER)
(425) 449-9710
Entity
Organization
Contact information
Practice address
17220 127TH PL NE STE 101A, WOODINVILLE, WA 98072-7965
(425) 449-9710
Mailing address
PO BOX 113, KIRKLAND, WA 98083-0113
Taxonomy
Speciality
Code
Description
License number
State
261QM0855X
Adolescent and Children Mental Health Clinic/Center
Primary
60097435
WA
Other
Enumeration date
05/01/2014
Last updated
05/01/2014
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