Healthcare Provider Details

I. General information

NPI: 1265346092
Provider Name (Legal Business Name): SHAWNA BONSEN OT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: SHAWNA RUTHERFORD

II. Dates (important events)

Enumeration Date: 09/29/2026
Last Update Date: 09/29/2026
Certification Date: 09/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

414 W BAKERVIEW RD STE 110
BELLINGHAM WA
98226-8180
US

IV. Provider business mailing address

8862 BENDER RD STE 101
LYNDEN WA
98264-8800
US

V. Phone/Fax

Practice location:
  • Phone: 360-752-5551
  • Fax: 360-752-0155
Mailing address:
  • Phone: 360-752-5551
  • Fax: 360-752-0155

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License NumberOT.OT.60504078
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: