Bacon, Krista

Bacon, Krista is an individual health care provider with primary practice located at 4001 Main St Ste 218 , Vancouver WA 98663-1888. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Clinical, Behavioral Health & Social Service Providers / Forensic. Behavioral Health & Social Service Providers / Forensic is her primary health care specialty. Bacon, Krista can be contacted via phone (360) 777-6915.

Contact Information

Primary practice address
4001 Main St Ste 218 Vancouver WA 98663-1888
Phone: (360) 777-6915
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 103TC0700X PY61395594 Washington
Behavioral Health & Social Service Providers / Forensic 103TF0200X PY61395594 Washington

Profile Details

NPI number 1770952699
LBN Legal business name Bacon, Krista
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 21st, 2015
Last updated Sep 18th, 2023 - about last year

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

Request for update

Popular Providers