Individual
MR. BENEDICT MARK M BUNAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
NP
Contact information
Practice address
18633 SE STARK ST STE 401, PORTLAND, OR 97233-5468
(503) 489-1760
Mailing address
12045 SE 5TH ST, VANCOUVER, WA 98683-5214
(904) 763-6796
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
202215281NP-PP
OR
Other
Enumeration date
09/27/2022
Last updated
09/27/2022
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