Individual
PHILLIP M CULLISON BONNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2211 NE 139TH ST, VANCOUVER, WA 98686-2742
(360) 487-1000
Mailing address
31001 NE TIMMEN RD, RIDGEFIELD, WA 98642-7709
(317) 225-0388
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
MD163266
OR
207R00000X
Internal Medicine Physician
Primary
MD60648236
WA
208M00000X
Hospitalist Physician
7734
AK
Other
Enumeration date
04/19/2010
Last updated
06/28/2022
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