Amy Grace Bonilla

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

Practice address

8111 N Chautauqua Blvd
Portland, OR 97217-7217

Phone

(503) 915-1430

NPI assigned

Jul 31, 2024

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Grace Bonilla Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1722384000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722384000000",
    "number": "1992534473",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8111 N CHAUTAUQUA BLVD",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972177217",
            "telephone_number": "503-915-1430"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8111 N CHAUTAUQUA BLVD",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972177217",
            "telephone_number": "503-915-1430"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BONILLA",
        "first_name": "AMY",
        "middle_name": "GRACE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-07-31",
        "last_updated": "2024-07-31",
        "certification_date": "2024-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "GRACE",
            "last_name": "BONILLA",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Mary Lou Bonham, BSN, MFT
• Erica Leah Boni
• Lelia Boniadi, OTR/L
• Ashley Bonifacio
• Allison D Bonifay, MA, LPC
• Arielle Bonilla
• Brenda Bonilla
• Kathleen Mulloy Bonilla, M.ED.
• Tony Leonard Bonillo, R.PH.
• Kerry Bonin

• All providers in Portland, OR
• Marriage & Family Therapist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 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.