Provider Demographics
NPI:1376552844
Name:HILL, BONNIE J (ARNP)
Entity Type:Individual
Prefix:
First Name:BONNIE
Middle Name:J
Last Name:HILL
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1708 YAKIMA AVE
Mailing Address - Street 2:STE 110
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98405-5300
Mailing Address - Country:US
Mailing Address - Phone:253-627-9151
Mailing Address - Fax:253-591-8892
Practice Address - Street 1:1708 YAKIMA AVE
Practice Address - Street 2:STE 110
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98405-5300
Practice Address - Country:US
Practice Address - Phone:253-627-9151
Practice Address - Fax:253-591-8892
Is Sole Proprietor?:No
Enumeration Date:2006-08-05
Last Update Date:2011-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP30002322367A00000X, 163WW0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
No163WW0101XNursing Service ProvidersRegistered NurseWomen's Health Care, Ambulatory
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA0204013OtherL & I
WA8940367OtherCRIME VICTIMS
WAP00303610OtherRAILROAD
WA8940614OtherCRIME VICTIMS
WA0204629OtherL & I
WA9606054Medicaid
WAG8859076Medicare PIN
WAG8859075Medicare PIN
WA8940367OtherCRIME VICTIMS