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Individual
BONITA PERRINE
Active
Individual
BONITA PERRINE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NURSE PRACTITIONER
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
61185124
WA
163WP0200X
Pediatric Registered Nurse
2458932
MN
363LP0200X
Pediatric Nurse Practitioner
Primary
61206206
WA
Other
Enumeration date
05/29/2020
Last updated
08/08/2025
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