Individual
MS. BONNIE MARIE DITTMANN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.A.
Contact information
Practice address
2011 4TH ST, LA GRANDE, OR 97850-2511
(541) 963-4139
(541) 429-6612
Mailing address
2105 CEDAR ST, LA GRANDE, OR 97850-1712
(828) 773-1166
(541) 429-6612
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA151196
OR
Other
Enumeration date
04/27/2010
Last updated
03/17/2018
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