Individual
BONNIE K KITTLESON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
10000 SE MAIN ST STE 350, PORTLAND, OR 97216-2474
(971) 262-9800
(971) 262-9899
Mailing address
10000 SE MAIN ST STE 350, PORTLAND, OR 97216-2474
(971) 262-9800
(971) 262-9899
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
200450048NP
OR
363L00000X
Nurse Practitioner
53108
ID
363LF0000X
Family Nurse Practitioner
200450048NP
OR
Other
Enumeration date
05/27/2005
Last updated
03/17/2018
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