Individual
THOMAS STEWART BONN
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
1315 NW 4TH ST, STE B, REDMOND, OR 97756-1328
(541) 923-7494
(541) 504-9153
Mailing address
11481 SW HALL BLVD, STE 201, PORTLAND, OR 97223-8403
(800) 219-8835
(503) 443-1402
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
1108710
TX
225100000X
Physical Therapist
Primary
3544
OR
225100000X
Physical Therapist
PT00007475
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
226558
—
OR
Enumeration date
11/16/2005
Last updated
07/08/2007
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