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Contact Information

BRENT BONFIGLIO
501 N DIXON ST
PORTLAND, OR97227-1804
 Phone: 503-347-7794
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

School

103TS0200X 62 Psychologist, Clinical
Indicates primary specialty

NPI Profile & details for BRENT BONFIGLIO · (Male)

NPI # 1154266799
Status Active
Credentials
Entity Individual
Enumeration date 04/21/2026
Last updated 04/21/2026 - About 1 months ago
Sole proprietor 1 No
Identifiers
  • OR License # 138261
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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