Provider Demographics
NPI:1063616357
Name:ASHER, BONNIE MARIE
Entity type:Individual
Prefix:
First Name:BONNIE
Middle Name:MARIE
Last Name:ASHER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:BONNIE
Other - Middle Name:MARIE
Other - Last Name:HUFF
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2645 PORTLAND RD NE
Mailing Address - Street 2:SUITE 120
Mailing Address - City:SALEM
Mailing Address - State:OR
Mailing Address - Zip Code:97301
Mailing Address - Country:US
Mailing Address - Phone:503-390-5637
Mailing Address - Fax:503-393-3135
Practice Address - Street 1:2645 PORTLAND RD NE
Practice Address - Street 2:SUITE 120
Practice Address - City:SALEM
Practice Address - State:OR
Practice Address - Zip Code:97301
Practice Address - Country:US
Practice Address - Phone:503-390-5637
Practice Address - Fax:503-393-3135
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-12
Last Update Date:2019-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORT1228101YP2500X
101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101Y00000XBehavioral Health & Social Service ProvidersCounselor