Cheryl Bongiovanni, PHD, RVT, CWS
Individual provider Active NPI Specialist · Lakeview, OR
NPI 1700824489 · NPPES record last updated Jul 13, 2026
Key facts
- NPI
- 1700824489
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Specialist 174400000X
- License
- CERTIFIED WOUND SPEC (OR)
- Practice address
- 700 S J St
Lakeview, OR 97630-1623 - Phone
- (541) 517-5169
- Fax
- (541) 947-3339
- NPI assigned
- Jun 3, 2006
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| CERTIFIED WOUND SPEC | OR | MD | Specialist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | CERTIFIED WOUND SPEC | OR | Yes |
Addresses
Primary practice location
700 S J St
Lakeview, OR 97630-1623
Mailing address
PO Box 108
Lakeview, OR 97630-0105
Phone (541) 517-5169
Other providers in Lakeview, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 13, 2026. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.