Individual
CHRISTINA BONGEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
7420 SW 3RD AVE, PORTLAND, OR 97219-2801
(503) 380-3906
Mailing address
7420 SW 3RD AVE, PORTLAND, OR 97219-2801
(503) 380-3906
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
1053031
OR
Other
Enumeration date
03/27/2014
Last updated
03/27/2014
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