Individual
AMANDA R BONNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
2101 NE 139TH ST, SUITE #460, VANCOUVER, WA 98686
(360) 487-2727
Mailing address
PO BOX 2077, PORTLAND, OR 97208-2077
(503) 413-3900
(503) 413-3710
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
MD166587
OR
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
Primary
MD60668472
WA
Other
Enumeration date
05/02/2012
Last updated
12/15/2019
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