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Contact Information

KRISTA BACON
4001 MAIN ST STE 218
VANCOUVER, WA98663-1888
 Phone: 360-777-6915
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Forensic

103TF0200X 62 Psychologist, Clinical
 

Clinical

103TC0700X 62 Psychologist, Clinical
Indicates primary specialty

NPI Profile & details for KRISTA BACON · (Female)

NPI # 1770952699
Status Active
Credentials
Entity Individual
Enumeration date 09/21/2015
Last updated 09/18/2023 - About 3 years ago
Sole proprietor 1 No
Identifiers
  • WA License # PY61395594
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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