Individual
ELIZABETH MAE BONGHI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
897 TAURNIC PL NW, BAINBRIDGE ISLAND, WA 98110-2760
(206) 790-2339
Mailing address
2430 NW MYHRE RD # 101, SILVERDALE, WA 98383-7669
(360) 328-5054
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
BONGHEM066OE
WA
Other
Enumeration date
08/15/2019
Last updated
08/23/2019
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