Individual
AMY GRACE BONILLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
8111 N CHAUTAUQUA BLVD, PORTLAND, OR 97217-7217
(503) 915-1430
Mailing address
8111 N CHAUTAUQUA BLVD, PORTLAND, OR 97217-7217
(503) 915-1430
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
—
—
Other
Enumeration date
07/31/2024
Last updated
07/31/2024
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