Individual
DR. JAN GARVER BACON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHD
Contact information
Practice address
9125 BRIDGEPORT WAY SW STE 102, LAKEWOOD, WA 98499-2448
(253) 254-8284
(253) 276-0082
Mailing address
9125 BRIDGEPORT WAY SW STE 102, LAKEWOOD, WA 98499-2448
(253) 254-8284
(253) 276-0082
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
PY00001639
WA
Other
Enumeration date
11/30/2005
Last updated
04/18/2018
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