Active NPI
Marianne H Bastin, M.S.,P.T.
- Physical Therapist
- Puyallup, WA
National Provider Identifier
1962556795
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT00003643
- Practice address
- 402 15TH Ave SE
#100
Puyallup, WA 98372-3709 - Phone
- (253) 697-5200
- Fax
- (253) 697-5145
- NPI assigned
- Jan 22, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | PT00003643 | WA | Primary |
Addresses
Primary practice location
402 15TH Ave SE
#100
Puyallup, WA 98372-3709
Mailing address
402 15TH Ave SE
#100
Puyallup, WA 98372-3709
Phone (253) 697-5200
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
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PT00003643 | WA | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1169424000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1962556795",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "402 15TH AVE SE",
"address_2": "#100",
"city": "PUYALLUP",
"state": "WA",
"postal_code": "983723709",
"telephone_number": "253-697-5200",
"fax_number": "253-697-5145"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "402 15TH AVE SE",
"address_2": "#100",
"city": "PUYALLUP",
"state": "WA",
"postal_code": "983723709",
"telephone_number": "253-697-5200",
"fax_number": "253-697-5145"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BASTIN",
"first_name": "MARIANNE",
"middle_name": "H",
"name_prefix": "Ms.",
"credential": "M.S.,P.T.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-01-22",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "WA",
"license": "PT00003643",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Puyallup, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.