Individual
MARISSA BONNELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
301 RIDINGS AVE, MOLALLA, OR 97038-9201
(503) 829-5591
Mailing address
1437 SW MONTGOMERY ST, PORTLAND, OR 97201-6005
(808) 895-1822
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
—
—
Other
Enumeration date
05/20/2016
Last updated
05/20/2016
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