Individual
ROSARIO P BONAFEDE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
5050 NE HOYT ST, STE 155, PORTLAND, OR 97213-2956
(503) 215-6819
(503) 215-6492
Mailing address
PO BOX 3158, PORTLAND, OR 97208-3158
(503) 215-6494
(503) 215-6644
Taxonomy
Speciality
Code
Description
License number
State
207RR0500X
Rheumatology Physician
Primary
MD16090
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
054416
—
OR
01
—
P00745121
RR MEDICARE
—
Enumeration date
06/20/2006
Last updated
10/08/2021
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