MR. MITCHELL TYLER BACON
NPI 1083967442
Marriage & Family Therapist in Portland, OR

Active since October 23, 2012PECOS EnrolledAccepts Medicare Assignment
3550 N INTERSTATE AVE, PORTLAND, OR 97227(800) 813-2000 Get Directions Write a Review

NPPES record last updated: December 21, 2021. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Dec 21, 2021, Mar 27, 2017 (2 updates tracked since 2017).

About Mr. Mitchell Tyler Bacon NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MR. MITCHELL TYLER BACON (NPI 1083967442) is an individual marriage & family therapist in Portland, Oregon, licensed in Oregon (T1282) and active in the NPI registry since October 2012. He is enrolled in Medicare PECOS and is a graduate of Other (2013).

NPPES Registry Identity

NPI1083967442
Entity TypeIndividualMale
Primary Taxonomy106H00000X
Provider Legal NameMR. MITCHELL TYLER BACON
Location Address3550 N INTERSTATE AVEPortland, OR 97227-1196
Mailing Address7454 N Monteith AvePortland, OR 97203-4265 · (603) 667-3282
Sole ProprietorNo
Medical School CMSOtherGraduated 2013
Enumeration DateOctober 23, 2012
Last NPPES UpdateDecember 21, 20212 updates tracked since enumeration
NPPES CertifiedDecember 21, 2021
NPI 1083967442 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyMarriage & Family TherapistBehavioral Health & Social Service Providers
Taxonomy Code106H00000X
Licenses Licensed in OR · T1282 Licensed in WA · LF60724149
Definition

A marriage and family therapist is a person with a master's degree in marriage and family therapy, or a master's or doctoral degree in a related mental health field with substantially equivalent coursework in marriage and family therapy, who receives supervised clinical experience, or a person who meets the state requirements to practice as a marriage and family therapist. A marriage and family therapist treats mental and emotional disorders within the context of marriage and family systems. A marriage and family therapist provides mental health and counseling services to individuals, couples, families, and groups.

3550 N INTERSTATE AVE, Portland, OR 97227

Accepted Insurance

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

Enrolled in Medicare and accepts Medicare assignment

Mr. Mitchell Tyler Bacon is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID5698126589
PECOS Enrollment IDI20240104002305, I20240129000235
Eligible to Order & Refer Part B Labs & Imaging Durable Medical Equipment Home Health Agency Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Counselor
3550 N INTERSTATE AVE
PORTLAND, OR 97227
Psychologist (Clinical)
3550 N INTERSTATE AVE
PORTLAND, OR 97227
Nurse Practitioner (Family)
3550 N INTERSTATE AVE
PORTLAND, OR 97227
Nurse Practitioner
3550 N INTERSTATE AVE
PORTLAND, OR 97227
Dietitian, Registered
3550 N INTERSTATE AVE, NUTRITION DEPARTMENT EAST INTERSTATE
PORTLAND, OR 97227
Pharmacy (Managed Care Organization Pharmacy)
3550 N INTERSTATE AVE
PORTLAND, OR 97227
Social Worker (Clinical)
3550 N INTERSTATE AVE
PORTLAND, OR 97227
Pharmacist (Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist)
3550 N INTERSTATE AVE
PORTLAND, OR 97227

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Mitchell Bacon's NPI number?

The NPI number for Mitchell Bacon is 1083967442. It was assigned to this individual provider in the NPPES registry on October 23, 2012.

Where is Mitchell Bacon located?

Mitchell Bacon practices at 3550 N Interstate Ave, Portland, OR 97227. The listed phone number is (800) 813-2000.

What is Mitchell Bacon's specialty?

The primary specialty registered for this NPI is Marriage & Family Therapist with taxonomy code 106H00000X.

Is Mitchell Bacon enrolled in Medicare?

Yes. Mitchell Bacon is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does Mitchell Bacon accept?

Health plans from Kaiser Permanente list Mitchell Bacon as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Mitchell Bacon was last updated on December 21, 2021. NPI Profile syncs with the weekly NPPES data releases published by CMS.