Individual
DR. IAN R BASTIAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2817 ROCK MERRITT AVE, FORT LIBERTY, NC 28310-0001
(910) 907-8460
(253) 968-0443
Mailing address
9040 JACKSON AVE, TACOMA, WA 98431-0001
(253) 968-1440
(253) 968-0443
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
33015
NE
Other
Enumeration date
04/04/2017
Last updated
07/03/2024
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