NPI 1649615089 · live from the CMS NPI Registry
Heather A Bacon, Ph.D.
Psychologist, Clinical in Hermiston, OR. National Provider Identifier 1649615089, active.
NPI record
| NPI | 1649615089 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Psychologist, Clinical 103TC0700X |
| Practice location | 230 Se 2nd St Ste A, Hermiston, OR 97838 |
| Practice phone | 541-289-7777 |
| Mailing address | 203 Se 2nd Street, Suite A, Hermiston, OR 97838 |
| Enumerated | April 29, 2013 |
| Last updated | March 16, 2021 |
| Sole proprietor | Yes |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Psychologist, Clinical primary | 103TC0700X | 2376 (OR) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.