Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Mr. Mitchell Tyler Bacon

Individual provider Marriage & Family Therapist · NPI 1083967442

Mr. Mitchell Tyler Bacon is a Marriage and Family Therapist in Portland, Oregon. Qualified in 2013, 13 years ago. Practices with Kaiser Foundation Health Plan of the Northwest, a 1,811-clinician group and accepts Medicare assignment. Licensed in Oregon and Washington.

Years since qualifying
13
Licensed in
OR, WA
In the registry since
2012
Specialties on file
2
Claim this listing Report a problem Suggest an edit

Practice location Address checks out

3550 N Interstate Ave
Portland, OR 97227-1196
Phone: (800) 813-2000
Show map & directions

Directions in Google Maps · Apple Maps · OpenStreetMap

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Marriage & Family Therapist (primary) Taxonomy 106H00000X · Licence T1282 (OR)
Marriage & Family Therapist Taxonomy 106H00000X · Licence LF60724149 (WA)

Record details

NPI number1083967442
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedOctober 23, 2012
Last updated in NPPESDecember 21, 2021
Certification dateDecember 21, 2021
Mailing address7454 N Monteith Ave, Portland, OR 97203-4265

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyMARRIAGE AND FAMILY THERAPIST
Medical schoolOTHER
Graduated 2013 (13 years in practice)
Group practice Kaiser Foundation Health Plan Of The Northwest — 1811 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

Other providers in Portland