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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