Holly V Bonadurer

Primary specialty

Massage TherapistTaxonomy code 225700000X

License

24884 Issued in OR

Practice address

4531 SE Belmont St Ste 312
Portland, OR 97215-1693

Phone

(541) 915-5949

NPI assigned

Feb 21, 2021

Sex

Female

Sole proprietor

Yes

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Feb 21, 2021.

{
    "created_epoch": "1613865600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1613865600000",
    "number": "1285228239",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4531 SE BELMONT ST STE 312",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972151693",
            "telephone_number": "541-915-5949"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4531 SE BELMONT ST STE 312",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972151693",
            "telephone_number": "541-915-5949"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BONADURER",
        "first_name": "HOLLY",
        "middle_name": "V",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-02-21",
        "last_updated": "2021-02-21",
        "certification_date": "2021-02-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "OR",
            "license": "24884",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Janelle M Bombara, RD
• Despoina Bompolaki, DDS, MS
• Bon Vivant Health and Wellness, LLC
• Catharine Ann Bon, M.D.
• Maria Therese Bonacci, MS, LPC
• Kimberly A Bonafede, OTR
• Rosario P Bonafede, MD
• Brooke Lauren Bonawitz, LPN
• Michael Flynn Bonazzola, MD
• Julia J Boncher, M.D.

• All providers in Portland, OR
• Massage Therapist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2021; 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.