Bonni Elizabeth Little | Portland, OR • PECOS Search

Bonni Elizabeth Little

Social Worker

Behavioral Health & Social Service Providers

3550 SE Woodward St, Portland, OR 97202-1552

(503) 234-7532 (615) 585-3084

PECOS Enrollment

Based on the most recent information from CMS, provider Bonni Elizabeth Little does not have current enrollment records in PECOS.

Part B
Medicare Part B
Not Enrolled
HHA
Home Health Agency
Not Enrolled
DME
Durable Medical Equipment
Not Enrolled
PMD
Power Mobility Device
Not Enrolled

CMS last updated its PECOS records yesterday at 12:57 PM.

Profile Details

Provider ID
1831347236
Provider Type
Individual
Full Name
Little, Bonni Elizabeth
Gender
Female

Sole Proprietor
No
Enumeration Date
8/28/2008
Last Updated
8/28/2008

Contact Information

Practice Location

3550 SE Woodward St, Portland, OR 97202-1552

Unlisted Fax

Mailing Location

8932 NE Davis St, Portland, OR 97220-5951

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 104100000X Primary	Description Social Worker Behavioral Health & Social Service Providers	License Unlisted Issuer