Individual
MS. MARY LOU BONHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BSN, MFT
Contact information
Practice address
1500 NE IRVING ST, SUITE 250, PORTLAND, OR 97232-2243
(503) 233-4356
Mailing address
6445 SE 71ST AVE, PORTLAND, OR 97206-6545
(541) 974-0777
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
—
—
Other
Enumeration date
10/04/2007
Last updated
10/04/2007
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