Provider Demographics
NPI:1003278516
Name:BONDSHU, WHITNEY ANNE (MSW)
Entity type:Individual
Prefix:
First Name:WHITNEY
Middle Name:ANNE
Last Name:BONDSHU
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:431 MARION LN
Mailing Address - Street 2:
Mailing Address - City:GRANTS PASS
Mailing Address - State:OR
Mailing Address - Zip Code:97527-5570
Mailing Address - Country:US
Mailing Address - Phone:541-852-8641
Mailing Address - Fax:
Practice Address - Street 1:8385 DIVISION RD
Practice Address - Street 2:
Practice Address - City:WHITE CITY
Practice Address - State:OR
Practice Address - Zip Code:97503-1176
Practice Address - Country:US
Practice Address - Phone:541-826-5853
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-03-23
Last Update Date:2021-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty