Organization
HEATHER A BACON, PH.D., LLC
Active
Other names
Rivercrest Behavioral Health & Wellness
Organization subpart
No
Provider details
NPI number
Authorized official
DR. HEATHER BACON PH.D. (OWNER)
(541) 289-7777
Entity
Organization
Contact information
Practice address
230 SE 2ND ST STE A, HERMISTON, OR 97838-2486
(541) 289-7777
(541) 289-7778
Mailing address
230 SE 2ND ST STE A, HERMISTON, OR 97838-2486
(541) 289-7777
(541) 289-7778
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
—
—
104100000X
Social Worker
—
—
207Q00000X
Family Medicine Physician
—
—
2084P0800X
Psychiatry Physician
—
—
Other
Enumeration date
03/02/2021
Last updated
03/02/2021
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