Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Miss. Bonnie Beth Wickham, PA

Individual provider Physician Assistant · NPI 1225058902

Miss. Bonnie Beth Wickham, PA is a Physician Assistant in Bend, Oregon. Qualified in 2005, 21 years ago. Practices with St Charles Health System Inc, a 383-clinician group, works from 3 locations and accepts Medicare assignment. Licensed in Texas.

Years since qualifying
21
Licensed in
TX
In the registry since
2006
What do these letters mean?
PA — Physician Assistant
A licensed clinician who examines, diagnoses and treats under a physician's supervision.

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Practice location Address checks out

61250 SE Coombs Pl
Bend, OR 97702-3704
Phone: (541) 706-5930
Fax: (541) 706-5931
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (2)

  • 12039 E Maple Springs Way, Palmer, AK 99645-9797 — (907) 745-9088
  • 402 W 26th St, San Angelo, TX 76903-2826 — (325) 658-1511

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence PA04799 (TX)

Record details

NPI number1225058902
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA
Sole proprietorNo
NPI enumeratedJuly 19, 2006
Last updated in NPPESJune 4, 2026
Certification dateJune 4, 2026

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2005 (21 years in practice)
Group practice St Charles Health System Inc — 383 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations3 on file with Medicare

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