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1114244498
BONNIE MARIE DITTMANN
LA GRANDE, OR
NPI
1114244498
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Former Name
BONNIE MARIE HAYSLETT
Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363A00000X Physician Assistant
(Licence: OR PA151196)
Enumeration Date
2010-04-27
Last Update Date
2018-03-17
Business Address
Ms. BONNIE MARIE DITTMANN P.A.
2011 4TH ST
LA GRANDE, OR 97850-2511
Phone number: 541-963-4139
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Mailing Address
Ms. BONNIE MARIE DITTMANN P.A.
2105 CEDAR ST
LA GRANDE, OR 97850-1712
Phone number: 828-773-1166
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