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NPI Code Detail

MEDICARE: RICARDO BONILLA CNA

MEDICARE:   RICARDO  BONILLA  CNA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1374U00000XHome Health AideNC1000763WA

General Provider Information

NPI Number : 1831731181
Entity Type Code : Individual
Provider Name (Legal Business Name) : RICARDO BONILLA CNA
Provider Business Mailing Address
First Line : 526 214TH ST SW APT B
Second Line :
City : BOTHELL
State : WA
Zip : 98021-7555
Country : US
Telephone Number : 425-361-5673
Fax Number :
Provider Business Practice Location Address
First Line : 2600 SW HOLDEN ST
Second Line :
City : SEATTLE
State : WA
Zip : 98126-3505
Country : US
Telephone Number : 206-933-7153
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/08/2019
Last Update Date : 10/08/2019

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Directions to “ RICARDO BONILLA CNA” Practice Location

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