| Doctor Name: | EDEN BONITO |
| NPI Number: | 1023383759 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | FNP |
| License Number: | 200240491RN |
| Business Practice Address: | 1303 Ne Cushing Dr Ste 100 Bend, OR - 977013887 |
| Business Phone Number: | 5413308226 |
| Business Fax Number: | 5413180373 |
| Mailing Address: | 1303 Ne Cushing Dr, Ste 100 BEND |
| State: | OR |
| Postal Code: | 977013887 |
| Phone Number: | 5413308226 |
| Fax Number: | 5413180373 |
| NPI Enumeration Date: | 03/13/2012 |
| NPI Last Update Date: | 03/13/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | 200240491RN |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | OR |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |