Individual
EMMA KIMBERLEE BACON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
14526 LINDSAY LOOP SE, YELM, WA 98597-8598
(360) 870-9160
Mailing address
14526 LINDSAY LOOP SE, YELM, WA 98597-8598
(360) 870-9160
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/04/2025
Last updated
04/04/2025
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