Healthcare Provider Details

I. General information

NPI: 1255253555
Provider Name (Legal Business Name): VALENTINA ACOSTA BONILLA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/28/2026
Last Update Date: 07/28/2026
Certification Date: 07/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

831 CALLAHAN DRIVE SUITE C
BREMERTON WA
98310
US

IV. Provider business mailing address

12427 THAYER LN NW APT 105
SILVERDALE WA
98383-7631
US

V. Phone/Fax

Practice location:
  • Phone: 360-240-0022
  • Fax:
Mailing address:
  • Phone: 407-470-4705
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: