Individual
BONTU ABERRA DERESSA
Active
Sole proprietor
No
Provider details
NPI number
Gender
X
Contact information
Practice address
3636 110TH LN NE, BLAINE, MN 55449-7702
(763) 318-8981
Mailing address
3636 110TH LN NE, BLAINE, MN 55449-7702
(763) 318-8981
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
—
—
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
06/01/2026
Last updated
06/01/2026
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