Tony Leonard Bonillo, R.Ph.
Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist in Portland, OR. Individual provider (NPI-1).
Details
- NPI
- 1508102435
- Entity type
- Individual (NPI-1)
- Name
- Tony Leonard Bonillo
- Credential
- R.Ph.
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Dec 20, 2012
- Last updated
- Apr 27, 2017
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 1835P0018X | Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist | 0009214 | OR | Yes |
| 183500000X | Pharmacist | 0009214 | OR |
Practice location
3030 Ne Weidler StPortland, OR 97232-1851
Phone 503-280-1333 · Fax 503-280-1327
Mailing address
3030 Ne Weidler StPortland, OR 97232-1851
Phone 503-280-1333 · Fax 503-280-1327
Is something wrong?
This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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