Individual provider Active NPI

Denae R. Bastian, RD

  • Nutrition Education Nutritionist
  • Everett, WA
National Provider Identifier
1508952748
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nutrition Education NutritionistTaxonomy code 133NN1002X
License
DI00001618 Issued in WA
Practice address
900 Pacific Ave
1St Floor
Everett, WA 98201-4168
Phone
(425) 258-7311
Fax
(425) 258-7618
NPI assigned
Oct 5, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X DI00001618 WA
Nutritionist 133N00000X DI00001618 WA
Nutrition Education Nutritionist 133NN1002X DI00001618 WA Primary

Addresses

Primary practice location

900 Pacific Ave
1St Floor
Everett, WA 98201-4168

Mailing address

PO Box 1166
Everett, WA 98206-1166
Phone (425) 258-7357

Other identifiers 1

IdentifierTypeStateIssuer
8429615MedicaidWA

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
DI00001618WAMDNutritionist

NPI Registry JSON

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

{
    "created_epoch": "1160006400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757548800000",
    "number": "1508952748",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1166",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "982061166",
            "telephone_number": "425-258-7357",
            "fax_number": "425-258-7022"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 PACIFIC AVE",
            "address_2": "1ST FLOOR",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "982014168",
            "telephone_number": "425-258-7311",
            "fax_number": "425-258-7618"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BASTIAN",
        "first_name": "DENAE",
        "middle_name": "R.",
        "credential": "RD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-05",
        "last_updated": "2025-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "WA",
            "license": "DI00001618",
            "primary": false
        },
        {
            "code": "133N00000X",
            "taxonomy_group": "",
            "desc": "Nutritionist",
            "state": "WA",
            "license": "DI00001618",
            "primary": false
        },
        {
            "code": "133NN1002X",
            "taxonomy_group": "",
            "desc": "Nutritionist, Nutrition, Education",
            "state": "WA",
            "license": "DI00001618",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8429615",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Everett, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; 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.