Individual
BONITA LAGINA WILCOX
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ND
Contact information
Practice address
330 SE 3RD ST, TROUTDALE, OR 97060-2080
(971) 270-0483
Mailing address
330 SE 3RD ST, TROUTDALE, OR 97060-2080
(971) 270-0483
Taxonomy
Speciality
Code
Description
License number
State
175F00000X
Naturopath
Primary
4082
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4082
BOARD LICENSE
OR
Enumeration date
08/01/2017
Last updated
07/21/2022
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