Bonta, Michelle D
Bonta, Michelle D is an individual health care provider with primary practice located at 417 Sw 117Th Ave 2Nd Floor, Portland OR 97225-5924. She recently has only one registered license in Allopathic & Osteopathic Physicians / Dermatology, which is considered as her primary health care specialty. Bonta, Michelle D can be contacted via phone (503) 216-9400.Contact Information
Primary practice address
417 Sw 117Th Ave 2Nd Floor
Portland OR 97225-5924
Phone: (503) 216-9400
Fax: (503) 216-9499
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Dermatology | 207N00000X | MD25129 | Oregon |
Profile Details
| NPI number | 1265468615 |
|---|---|
| LBN Legal business name | Bonta, Michelle D |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 25th, 2006 |
| Last updated | Oct 15th, 2020 - about 4 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1265468615 | NPPES |
| Oregon | Other | P00207043 | RR MEDICARE - PH&S |
| Oregon | MEDICAID | 233462 | RR MEDICARE - PH&S |
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