Bacon, Odessa Ann

Bacon, Odessa Ann is an sole proprietor health care provider with primary practice located at 9330 59Th Ave Sw , Lakewood WA 98499-2858. She recently has 2 registered licenses in different health care specialties including Nursing Service Providers / Registered Nurse, Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health. Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health is her primary health care specialty. Bacon, Odessa Ann can be contacted via phone (253) 936-5937.

Contact Information

Primary practice address
9330 59Th Ave Sw Lakewood WA 98499-2858
Phone: (253) 936-5937
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Nursing Service Providers / Registered Nurse 163W00000X RN00175337 Washington
Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health 363LP0808X AP61005962 Washington

Profile Details

NPI number 1801077169
LBN Legal business name Bacon, Odessa Ann
Credentials ARNP, PMHNP-BC
Entity Individual
Sole proprietor 1 Yes
Enumeration date Nov 15th, 2007
Last updated Nov 4th, 2019 - about 6 years ago

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.

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