Michelle D Bonta (NPI# 1265468615, PAC ID# 6709851363) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is DERMATOLOGY.
| Nation Provider ID (NPI) | 1265468615 |
| PAC ID by PECOS | 6709851363 |
| Professional Enrollment ID | I20040827000927 |
| Full Name | Michelle D Bonta |
| Organization Legal Name | PROVIDENCE HEALTH AND SERVICES OREGON |
| Address |
5050 Ne Hoyt 454 Providence Med Group Portland OR 97213-2984 |
| Phone Number | 5032156405 |
| Gender | F |
| Credential | MD |
| Medical School | HARVARD MEDICAL SCHOOL |
| Graduation Year | 2000 |
| Primary Specialty | DERMATOLOGY |
| Group Practice PAC ID | 0648183608 |
| Number of Group Practice Members | 1163 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 380061 | PROVIDENCE PORTLAND MEDICAL CENTER |
| 380004 | PROVIDENCE ST VINCENT MEDICAL CENTER |
| Address | Phone | Organization |
|---|---|---|
| 417 Sw 117th Ave, Portland, OR 97225-5924 | PROVIDENCE HEALTH AND SERVICES OREGON | |
| 5050 Ne Hoyt, 454 Providence Med Group, Portland, OR 97213-2984 | 5032156405 | PROVIDENCE HEALTH AND SERVICES OREGON |
| 5050 Ne Hoyt St, Portland, OR 97213-2984 | PROVIDENCE HEALTH AND SERVICES OREGON | |
| 9205 Sw Barnes Rd, Portland, OR 97225-6603 | 5032161234 | PROVIDENCE HEALTH AND SERVICES OREGON |
| 9205 Sw Barnes Rd, Suite 495, Portland, OR 97225-6603 | 5032161182 | PROVIDENCE HEALTH AND SERVICES OREGON |
| 9205 Sw Barnes Rd Mt, 2800 Prov Med Gr St Vince, Portland, OR 97225-6603 | 5032162621 | PROVIDENCE HEALTH AND SERVICES OREGON |
| Organization Legal Name | PROVIDENCE HEALTH AND SERVICES OREGON |
| Physicians | 1491 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Yeong Paul Park | Physical Therapy | Providence Health and Services Oregon | 1627 Woods Ct, Prov Gorg Spi/spo M, Hood River, OR 97031-2915 |
| Traci Ackron | Family Medicine | Providence Health and Services Oregon | 909 Sw 18th Ave, Prov Med Gr Spor Car, Portland, OR 97205-1705 |
| Tierney Newman | Nurse Practitioner | Providence Health and Services Oregon | 4004 Kruse Way Pl, Suite 300, Lake Oswego, OR 97035-2479 |
| Angie R Cronin | Psychologist, Clinical | Providence Health and Services Oregon | 1332 S Shasta Ave, Suite A, Eagle Point, OR 97524-8623 |
| Jennifer N Herr | Nurse Practitioner | Providence Health and Services Oregon | 4805 Ne Glisan, Portland, OR 97213-2933 |
| Jaecelle Guadiz Galeniece | Family Medicine | Providence Health and Services Oregon | 1003 Providence Dr, Suite 325, Newberg, OR 97132-7521 |
| Amelia H Baker | Family Medicine | Providence Health and Services Oregon | 4920 N Interstate Ave, Portland, OR 97217-3653 |
| Sandra Iloka | Family Medicine | Providence Health and Services Oregon | 16770 Sw Edy Rd, 102 Pmg Sherwood Imed Cr, Sherwood, OR 97140-9679 |
| Duy Quang Tran | Family Medicine | Providence Health and Services Oregon | 839 Ne Holladay St, Portland, OR 97232-3521 |
| Steven Vorenkamp | Orthopedic Surgery | Providence Health and Services Oregon | 814 13th St, Hood River, OR 97031-1210 |
| Street Address |
5050 NE HOYT 454 PROVIDENCE MED GROUP |
| City | PORTLAND |
| State | OR |
| Zip | 97213-2984 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Jonathan L Vinson | Family Medicine | Providence Health and Services Oregon | 5050 Ne Hoyt, 454 Providence Med Group, Portland, OR 97213-2984 |
| Rachel Plotinsky | Infectious Disease | Providence Health and Services Oregon | 5050 Ne Hoyt, 454 Providence Med Group, Portland, OR 97213-2984 |
| Alice C Nayak | Internal Medicine | Providence Health and Services Oregon | 5050 Ne Hoyt, 454 Providence Med Group, Portland, OR 97213-2984 |
| Darlene Joyce Dodson | Obstetrics/gynecology | Providence Health and Services Oregon | 5050 Ne Hoyt, 454 Providence Med Group, Portland, OR 97213-2984 |
| Cristian Vallejos | Gastroenterology | Oregon Clinic PC | 5050 Ne Hoyt, Suite 655, Portland, OR 97213-2990 |
| Poombavai O Nagappan | Internal Medicine | Providence Health and Services Oregon | 5050 Ne Hoyt, 454 Providence Med Group, Portland, OR 97213-2984 |
| David C Childers | Internal Medicine | Providence Health and Services Oregon | 5050 Ne Hoyt, 454 Providence Med Group, Portland, OR 97213-2984 |
| Reda T Bassaly | Physician Assistant | Oregon Clinic PC | 5050 Ne Hoyt, Suite 655, Portland, OR 97213-2990 |
| Duane A Lundeberg | Otolaryngology | Oregon Clinic PC | 5050 Ne Hoyt, Suite 655, Portland, OR 97213-2990 |
| Scott Marsal | Hospitalist | Providence Health and Services Oregon | 5050 Ne Hoyt, 454 Providence Med Group, Portland, OR 97213-2984 |
| Find all physicians in the same address | |||
| Name | Specialty | Organization | Address |
|---|---|---|---|
| John R Lewis | Optometry | Beaumont Vision, PC | 4331 Ne Fremont St, Portland, OR 97213-1151 |
| David M Klipper | Diagnostic Radiology | Kern Radiology Medical Group Inc | 4231 Ne Siskiyou St, Portland, OR 97213-1161 |
| Evonne N Serpa | Qualified Audiologist | 4311 Ne Tillamook St, Portland, OR 97213-1315 | |
| Judith J Chambers | Clinical Social Worker | 1804 Ne 45th Ave, Portland, OR 97213-1416 | |
| Diane Squire Hyde | Clinical Social Worker | 1804 Ne 45th Ave, Portland, OR 97213-1416 | |
| Marjorie J Hrbek | Internal Medicine | Broadway Medical Clinic LLP | 4212 Ne Broadway, Portland, OR 97213-1422 |
| Mary Lee Baker | Pediatric Medicine | Broadway Medical Clinic LLP | 4212 Ne Broadway, Portland, OR 97213-1422 |
| Lorelei Elizabeth Ditommaso | Dermatology | Broadway Medical Clinic LLP | 4212 Ne Broadway, Portland, OR 97213-1422 |
| Tracy L Hansen | Internal Medicine | Broadway Medical Clinic LLP | 4212 Ne Broadway, Portland, OR 97213-1422 |
| Anne M Hirsch | Internal Medicine | Broadway Medical Clinic LLP | 4212 Ne Broadway, Portland, OR 97213-1422 |
| Find all physicians in zip 97213 | |||
| City | PORTLAND |
| Zip Code | 97213 |
| Specialty | DERMATOLOGY |
| City + Specialty | PORTLAND + DERMATOLOGY |
Please comment or provide details below to improve the information on Michelle D Bonta.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.