Brenda Bonilla, is a medicare enrolled "Social Worker - Clinical" provider in Portland, Oregon. Her current practice location is
3181 Sw Sam Jackson Park Rd, Portland, Oregon. You can reach out to her office (for appointments etc.) via phone at
(503) 494-2273.
Brenda Bonilla is licensed to practice in Oregon (license number L11371) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1003342155.
Healthcare Provider's Profile
Full Name | Brenda Bonilla |
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Gender | Female |
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Speciality | Social Worker - Clinical |
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Location | 3181 Sw Sam Jackson Park Rd, Portland, Oregon |
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Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
NPI Data:
- NPI Number: 1003342155
- Provider Enumeration Date: 05/11/2017
- Last Update Date: 10/15/2024
Medicare PECOS Information:
- PECOS PAC ID: 2264875319
- Enrollment ID: I20240206003320
Medical Identifiers
Medical identifiers for Brenda Bonilla such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1003342155 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
101YM0800X | Counselor - Mental Health | 97763 (California) | Secondary |
1041C0700X | Social Worker - Clinical | L11371 (Oregon) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Brenda Bonilla is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
Brenda Bonilla, 1400 Sw 5th Ave Ste 500, Portland, OR 97201-5537 Ph: (866) 617-6855 | Brenda Bonilla, 3181 Sw Sam Jackson Park Rd, Portland, OR 97239-3011 Ph: (503) 494-2273 |
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