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Individual

LEONARD JAZZEL BONUS JR.

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
CRNA

Contact information

Practice address
10180 SE SUNNYSIDE RD, CLACKAMAS, OR 97015-8970
(800) 813-2000
Mailing address
500 NE MULTNOMAH ST STE 100, PORTLAND, OR 97232-2031

Taxonomy

Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
10050197
OR
367500000X
Certified Registered Nurse Anesthetist
1137544
TX

Other

Enumeration date
10/11/2023
Last updated
01/16/2026
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