Provider Demographics
NPI:1306421599
Name:BONTE, ERICA
Entity type:Individual
Prefix:
First Name:ERICA
Middle Name:
Last Name:BONTE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:305 COLLEGE ST NE
Mailing Address - Street 2:
Mailing Address - City:LACEY
Mailing Address - State:WA
Mailing Address - Zip Code:98516-5390
Mailing Address - Country:US
Mailing Address - Phone:360-412-4400
Mailing Address - Fax:360-412-4410
Practice Address - Street 1:305 COLLEGE ST NE
Practice Address - Street 2:
Practice Address - City:LACEY
Practice Address - State:WA
Practice Address - Zip Code:98516-5390
Practice Address - Country:US
Practice Address - Phone:360-412-4400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-03-10
Last Update Date:2025-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist