Individual
JONNI BACON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
401 BUSTER RD, TOPPENISH, WA 98948-9792
(509) 865-2102
Mailing address
2502 WOOLSEY RD UNIT D, YAKIMA, WA 98903-5810
(406) 224-1475
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
NUR-RN-LIC-177340
MT
Other
Enumeration date
01/10/2023
Last updated
01/10/2023
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