Individual provider Active NPI

Jessica Lynn Bastine, RN

  • Registered Nurse
  • Spokane Valley, WA
National Provider Identifier
1053918730
Registry record updated Oct 6, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
RN60730152 Issued in WA
Practice address
411 S Evergreen Rd
Spokane Valley, WA 99216-0626
Phone
(509) 701-9650
Fax
(509) 878-4078
NPI assigned
Oct 6, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 6, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X RN60730152 WA Primary

Addresses

Primary practice location

411 S Evergreen Rd
Spokane Valley, WA 99216-0626

Mailing address

411 S Evergreen Rd
Spokane Valley, WA 99216-0626
Phone (509) 701-9650

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
RN60730152WAMDRegistered Nurse

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1601942400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1601942400000",
    "number": "1053918730",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "411 S EVERGREEN RD",
            "city": "SPOKANE VALLEY",
            "state": "WA",
            "postal_code": "992160626",
            "telephone_number": "509-701-9650",
            "fax_number": "509-878-4078"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "411 S EVERGREEN RD",
            "city": "SPOKANE VALLEY",
            "state": "WA",
            "postal_code": "992160626",
            "telephone_number": "509-701-9650",
            "fax_number": "509-878-4078"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BASTINE",
        "first_name": "JESSICA",
        "middle_name": "LYNN",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-10-06",
        "last_updated": "2020-10-06",
        "certification_date": "2020-10-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "WA",
            "license": "RN60730152",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Spokane Valley, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 6, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.