Individual
AMITY ELIZABETH BONHAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4526 FEDERAL AVE, EVERETT, WA 98203-2132
(425) 349-6200
Mailing address
305 BRAVO ST, MOXEE, WA 98936-5906
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
03/16/2021
Last updated
03/16/2021
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