Individual
TONY LEONARD BONILLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
R.PH.
Contact information
Practice address
3030 NE WEIDLER ST, PORTLAND, OR 97232-1851
(503) 280-1333
(503) 280-1327
Mailing address
3030 NE WEIDLER ST, PORTLAND, OR 97232-1851
(503) 280-1333
(503) 280-1327
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
0009214
OR
1835P0018X
Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
Primary
0009214
OR
Other
Enumeration date
12/20/2012
Last updated
04/27/2017
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