Individual provider Active NPI

Bonnie Jo Gonzalez, MA, LMFT

  • Marriage & Family Therapist
  • Mountlake Terrace, WA
National Provider Identifier
1861638298
Registry record updated Jul 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
LF60161889 Issued in WA
Practice address
5508 234TH St SW
Mountlake Terrace, WA 98043-4746
Phone
(425) 213-3041
Fax
(425) 670-2526
NPI assigned
Jan 7, 2009
Last updated
Jul 16, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 16, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X LF60161889 WA Primary

Addresses

Primary practice location

5508 234TH St SW
Mountlake Terrace, WA 98043-4746

Mailing address

5508 234TH St SW
Mountlake Terrace, WA 98043-4746
Phone (425) 213-3041

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240207000033 WA Practitioner - Marriage and Family Therapist 5597108589 Practice locations: Mountlake Terrace, WA

Care Compare profile

Medicare Care Compare
Specialty
Marriage and Family Therapist
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

5508 234TH St SW
Mountlake Terrace, WA 98043-4746
Phone (425) 213-3041

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts

NPI Registry JSON

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

{
    "created_epoch": "1231286400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721088000000",
    "number": "1861638298",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5508 234TH ST SW",
            "city": "MOUNTLAKE TERRACE",
            "state": "WA",
            "postal_code": "980434746",
            "telephone_number": "425-213-3041",
            "fax_number": "425-670-2526"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5508 234TH ST SW",
            "city": "MOUNTLAKE TERRACE",
            "state": "WA",
            "postal_code": "980434746",
            "telephone_number": "425-213-3041",
            "fax_number": "425-670-2526"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GONZALEZ",
        "first_name": "BONNIE",
        "middle_name": "JO",
        "credential": "MA, LMFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-01-07",
        "last_updated": "2024-07-16",
        "certification_date": "2024-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "WA",
            "license": "LF60161889",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mountlake Terrace, WA

Sources for this page

Verify at the official NPI Registry.