Individual
MR. JOHN A. BACON
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
525 SW 6TH ST, CORVALLIS, OR 97333-4323
(541) 752-0834
Mailing address
525 SW 6TH ST, CORVALLIS, OR 97333-4323
(541) 752-0834
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
LCSW #975
OR
Other
Enumeration date
11/02/2005
Last updated
07/08/2007
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