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Organization

HEATHER A BACON, PH.D., LLC

Active
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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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