Individual
KELLY BASTIAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4815 N ASSEMBLY ST, SPOKANE, WA 99205-6185
(509) 434-7271
Mailing address
813 E WESTCREST RD, COLBERT, WA 99005-8725
(509) 381-9999
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
RN60630490
WA
Other
Enumeration date
11/22/2021
Last updated
11/22/2021
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