Individual
JEFFREY PRATT BASTIAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS, MS
Contact information
Practice address
14320 50TH AVE SE, EVERETT, WA 98208-8985
(425) 359-0897
Mailing address
14320 50TH AVE SE, EVERETT, WA 98208-8985
(425) 359-0897
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
DENT.DE.70030464
WA
Other
Enumeration date
01/05/2026
Last updated
01/05/2026
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