Justin Michael Bonanno, RN

Primary specialty

Emergency Registered NurseTaxonomy code 163WE0003X

License

RN60979296 Issued in WA

Practice address

939 Caroline St
Port Angeles, WA 98362-3997

Phone

(360) 417-7000

NPI assigned

Jul 4, 2024

Last updated

Jul 4, 2024By the provider in NPPES

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Nurse

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1720051200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1720051200000",
    "number": "1144066531",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "136 ORCAS AVE",
            "city": "PORT ANGELES",
            "state": "WA",
            "postal_code": "983622552",
            "telephone_number": "424-212-2515"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "939 CAROLINE ST",
            "city": "PORT ANGELES",
            "state": "WA",
            "postal_code": "983623997",
            "telephone_number": "360-417-7000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BONANNO",
        "first_name": "JUSTIN",
        "middle_name": "MICHAEL",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-07-04",
        "last_updated": "2024-07-04",
        "certification_date": "2024-07-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WE0003X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Emergency",
            "state": "WA",
            "license": "RN60979296",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Samone Blunk, M.D.
• Linda Marie Boardman
• Traci E Boe, LMP
• Ty Mathew Boe, CDPT
• Lesa M Bolts-Krick
• Deborah Grace Bopp, ARNP
• Kevin Leigh Borde, RPH
• Raymond Borgen, R.N.
• Diana Bossell
• Jordan Boston

• Emergency Registered Nurse in Port Angeles, WA
• Providers in Port Angeles, WA by specialty
• Emergency Registered Nurse in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 4, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.