Individual
ADRIENNE D BONHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
3181 SW SAM JACKSON PARK RD, PORTLAND, OR 97239-3011
(503) 418-4500
(503) 494-1678
Mailing address
3181 SW SAM JACKSON PARK RD, PORTLAND, OR 97239-3011
(503) 418-4500
(503) 494-1678
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
219700
NY
207V00000X
Obstetrics & Gynecology Physician
219700
NY
207V00000X
Obstetrics & Gynecology Physician
Primary
MD204324
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02169006
—
NY
Enumeration date
11/01/2006
Last updated
07/09/2021
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