Individual
BRENT BONFIGLIO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
501 N DIXON ST, PORTLAND, OR 97227-1804
(503) 347-7794
Mailing address
3946 NE FAILING ST, PORTLAND, OR 97212-1945
(503) 347-7794
Taxonomy
Speciality
Code
Description
License number
State
103TS0200X
School Psychologist
Primary
138261
OR
Other
Enumeration date
04/21/2026
Last updated
04/21/2026
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