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1033665898
BONITA BAXTER
GRESHAM, OR
NPI
1033665898
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
Enumeration Date
2016-08-31
Last Update Date
2016-08-31
Business Address
-- BONITA BAXTER
400 NE 7TH STREET
GRESHAM, OR 97030
Phone number: 503-661-5455
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Mailing Address
-- BONITA BAXTER
14600 NW CORNELL ROAD
PORTLAND, OR 97229
Phone number:
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