Individual
TERESA BONN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
14600 NW CORNELL RD, PORTLAND, OR 97229-5442
(503) 645-3581
Mailing address
17744 SW IVY GLENN DR, BEAVERTON, OR 97007-4771
(503) 560-3388
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
—
—
Other
Enumeration date
02/01/2019
Last updated
03/01/2019
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